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Individual

DR. TRACY R JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-2710
(210) 358-4739
Mailing address
7703 FLOYD CURL DR, MC7977, SAN ANTONIO, TX 78229-3901
(210) 450-4000
(210) 450-4903

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
K0322
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
181733005
TX
01
181733006
CSHCN
TX
Enumeration date
06/14/2006
Last updated
02/09/2011
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