Provider Information for 1528813086
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CHRISTOPHER CODY JOHNSON
Sex: Male
NPI: 1528813086
Last Updated: 2024-04-18
Certification Date: 2024-04-18
Certification Date: 2024-04-18
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1528813086 | ||||||||
| Enumeration Date | 2024-04-18 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 623 BLANNING DR DALLAS, TX 75218-1742 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 623 BLANNING DR DALLAS, TX 75218-1742 United States Phone: 214-287-8658 | Fax: | ||||||||
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