Provider Demographics
NPI:1184210353
Name:WALKER, JOHNAL JR (RN)
Entity Type:Individual
Prefix:
First Name:JOHNAL
Middle Name:
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MISTY LEA LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-1233
Mailing Address - Country:US
Mailing Address - Phone:346-290-8496
Mailing Address - Fax:
Practice Address - Street 1:7115 NORTH LOOP E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028-5948
Practice Address - Country:US
Practice Address - Phone:866-544-6741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX783026163WH0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0500XNursing Service ProvidersRegistered NurseHemodialysis