Individual
RAYMOND LOUIS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
327 CORAL SEA RD, SUITE 165, INGLESIDE, TX 78362-5055
(361) 776-1374
(361) 776-1103
Mailing address
327 CORAL SEA RD, SUITE 165, INGLESIDE, TX 78362-5055
(361) 776-1374
(361) 776-1103
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/05/2007
Last updated
09/05/2007
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