Individual
SAM JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12250 INWOOD RD, SUITE 7, DALLAS, TX 75244-8033
(972) 701-9700
Mailing address
101 S BROOKSIDE DR APT 2207, DALLAS, TX 75214-4585
(214) 557-0624
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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