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Individual

STEVEN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3201 S LOOP 256 STE 630, PALESTINE, TX 75801-6905
(903) 723-0330
(903) 723-2407
Mailing address
4002 S LOOP 256, SUITE G, PALESTINE, TX 75801-8491
(903) 723-2427
(903) 723-2407

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
P5390
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
325724YMAF
MEDICARE
TX
01
75-0818167-051
TRICARE
TX
01
75-2616977-015
TRICARE
TX
01
752616977015
TRICARE
TX
Enumeration date
10/24/2007
Last updated
12/17/2024
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