Individual
DR. KENNETH B JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12720 HILLCREST RD STE 300, DALLAS, TX 75230-2089
(214) 814-1550
(214) 814-1350
Mailing address
9330 LBJ FWY STE 800, DALLAS, TX 75243-4310
(972) 792-5700
(214) 506-1107
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
J8608
TX
207RI0011X
Interventional Cardiology Physician
Primary
J8608
TX
207UN0901X
Nuclear Cardiology Physician
J8608
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103576801
—
TX
05
—
103576803
—
TX
Enumeration date
04/14/2006
Last updated
05/30/2024
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