Individual
DR. CALISSTA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2500 S LAKELINE BLVD STE 202, CEDAR PARK, TX 78613-2969
(512) 628-1090
(512) 628-1089
Mailing address
2500 S LAKELINE BLVD STE 202, CEDAR PARK, TX 78613-2969
(512) 628-1090
(512) 628-1089
Taxonomy
Speciality
Code
Description
License number
State
1835N1003X
Nutrition Support Pharmacist
Primary
55618
TX
Other
Enumeration date
06/02/2021
Last updated
06/02/2021
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