Individual
SHATERIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
850 LAKE CAROLYN PKWY APT 3146, IRVING, TX 75039-4440
(469) 864-9931
Mailing address
850 LAKE CAROLYN PKWY APT 3146, IRVING, TX 75039-4440
(469) 864-9931
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
TX
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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