Organization
SHANNON A. JOHNSON M.D., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON ANDREA JOHNSON M.D. (PRESIDENT)
(817) 283-7400
Entity
Organization
Contact information
Practice address
3901 AIRPORT FWY, SUITE 320, BEDFORD, TX 76021-6117
(817) 283-7400
(817) 283-7406
Mailing address
PO BOX 1250, ROWLETT, TX 75030-1250
(817) 283-7400
(817) 283-7406
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
K7174
TX
Other
Enumeration date
11/14/2009
Last updated
02/01/2010
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