Individual
MRS. LISA ANN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,RD,CSG, LD,CDE
Contact information
Practice address
7400 MERTON MINTER ST, SAN ANTONIO, TX 78229-4404
(210) 616-8238
Mailing address
1244 BUMP GATE RD, PIPE CREEK, TX 78063-5306
(830) 510-4766
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT02095
TX
Other
Enumeration date
09/27/2006
Last updated
09/23/2011
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