Individual
JACK ALSTON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2300 LONE STAR RD, MANSFIELD, TX 76063-8744
(877) 847-9355
Mailing address
6451 BRENTWOOD STAIR RD STE 200, FORT WORTH, TX 76112-3200
(817) 496-9700
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
R9985
TX
Other
Enumeration date
04/20/2017
Last updated
11/06/2020
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