Provider Demographics
NPI:1851038350
Name:CALDWELL-JOHNSON PLLC
Entity Type:Organization
Organization Name:CALDWELL-JOHNSON PLLC
Other - Org Name:RIDGE CREEK FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:254-301-7166
Mailing Address - Street 1:15190 BADGER RANCH BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-8984
Mailing Address - Country:US
Mailing Address - Phone:254-301-7166
Mailing Address - Fax:254-824-3297
Practice Address - Street 1:15190 BADGER RANCH BLVD STE 102
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-8984
Practice Address - Country:US
Practice Address - Phone:254-301-7166
Practice Address - Fax:254-824-3297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-16
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care