Individual
DR. DAVID O JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
731 E SOUTHLAKE BLVD, SUITE 100, SOUTHLAKE, TX 76092-6377
(817) 912-8800
(817) 912-8810
Mailing address
731 E SOUTHLAKE BLVD, SUITE 100, SOUTHLAKE, TX 76092-6377
(817) 912-8800
(817) 912-8810
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
E4432
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1378663-01
—
TX
01
—
88X564
BCBS
TX
Enumeration date
07/26/2006
Last updated
06/11/2015
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