Provider Demographics
NPI:1114997186
Name:JONES, JOHNNA KAY (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHNNA
Middle Name:KAY
Last Name:JONES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JOHNNA
Other - Middle Name:KAY
Other - Last Name:KNUST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 8TH AVE STE 116
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-2606
Mailing Address - Country:US
Mailing Address - Phone:682-224-5705
Mailing Address - Fax:855-227-8089
Practice Address - Street 1:800 8TH AVE STE 116
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2606
Practice Address - Country:US
Practice Address - Phone:682-224-5705
Practice Address - Fax:855-227-8089
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4472208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154317504Medicaid
TX154317505Medicaid
TXH67047Medicare UPIN
TX154317505Medicaid
TX154317504Medicaid