Individual
CHERALAINE E. COLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1400 N WESTMORELAND RD, DEHARO-SALDIVAR HEALTH CENTER, DALLAS, TX 75211-1656
(214) 266-0500
(214) 266-0554
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00766
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060352402
—
TX
05
—
060352403
—
TX
05
—
060352404
—
TX
05
—
060352405
—
TX
01
—
8N4452
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/06/2005
Last updated
09/03/2009
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