Individual
JACALYN N. JOHNSON-ALVIZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
1220 HOLCOMBE BLVD, UNIT 1258, HOUSTON, TX 77030-4004
(713) 563-8500
(713) 563-8501
Mailing address
1220 HOLCOMBE BLVD, UNIT 1258, HOUSTON, TX 77030-4004
(713) 563-8500
(713) 563-8501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05001
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA05001
PA LICENSE
TX
Enumeration date
12/01/2006
Last updated
07/26/2010
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