Individual
DR. TARA LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3533 S ALAMEDA ST, CORPUS CHRISTI, TX 78411-1721
(361) 694-5000
(361) 694-5000
Mailing address
3533 S ALAMEDA ST, CORPUS CHRISTI, TX 78411-1721
(361) 694-4520
(361) 851-6867
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
E-11312
AR
208000000X
Pediatrics Physician
MT198880
MD
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
V4683
TX
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
V4683
TX
Other
Enumeration date
01/13/2010
Last updated
11/20/2024
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