Individual
KEVIN D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3810 HUGHES CT, DICKINSON, TX 77539-6205
(936) 639-3036
(936) 639-3064
Mailing address
PO BOX 1141, DICKINSON, TX 77539-1141
(936) 639-3036
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
046986
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82689U
BCBS
TX
Enumeration date
07/18/2006
Last updated
03/05/2008
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