Provider Demographics
NPI:1568971299
Name:JOHNSON, CALMONY
Entity Type:Individual
Prefix:
First Name:CALMONY
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 CANYON CREEK DR STE 140
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3273
Mailing Address - Country:US
Mailing Address - Phone:254-774-7727
Mailing Address - Fax:254-771-1256
Practice Address - Street 1:1618 CANYON CREEK DR STE 140
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3273
Practice Address - Country:US
Practice Address - Phone:254-774-7727
Practice Address - Fax:254-771-1256
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80808237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist