Individual
BRYAN S JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2000 S MAYS ST STE 201, ROUND ROCK, TX 78664-7580
(512) 244-4272
(512) 244-2895
Mailing address
2000 S MAYS ST STE 201, ROUND ROCK, TX 78664-7580
(512) 244-4272
(512) 244-2895
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04205
TX
363AS0400X
Surgical Physician Assistant
PA04205
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200086106
—
TX
Enumeration date
03/07/2006
Last updated
04/13/2021
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