Individual
DR. KEITH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1904 GRANDSTAND DR, SUITE 400, SAN ANTONIO, TX 78238-4508
(210) 520-8071
(210) 521-7688
Mailing address
28409 QUADRILLE LN, FAIR OAKS RANCH, TX 78015-4633
(210) 520-8070
(210) 521-7688
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G3499
TX
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
G3499
TX
Other
Enumeration date
03/21/2006
Last updated
11/23/2011
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