Individual
MELVIN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1016 GRAND NATIONAL BLVD, FORT WORTH, TX 76179-2336
(817) 657-7640
Mailing address
1016 GRAND NATIONAL BLVD, FORT WORTH, TX 76179-2336
(817) 657-7640
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
02/12/2015
Last updated
11/14/2018
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