Individual
DR. LORI ANGELA JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2200 BERGQUIST DR, SUITE 1 ATTN: CREDENTIALS (CMC), LACKLAND A F B, TX 78236-9907
(210) 292-6707
Mailing address
4414 SHAVANO CROSS, SAN ANTONIO, TX 78230-5821
(210) 479-3507
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K3766
TX
Other
Enumeration date
01/25/2006
Last updated
07/08/2007
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