Provider Demographics
NPI:1649436627
Name:JOHNSON MEDICAL ASSOCIATES, P.A.
Entity type:Organization
Organization Name:JOHNSON MEDICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:R
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-479-0400
Mailing Address - Street 1:997 HAMPSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-8105
Mailing Address - Country:US
Mailing Address - Phone:972-479-0400
Mailing Address - Fax:972-479-9435
Practice Address - Street 1:997 HAMPSHIRE LN
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-8105
Practice Address - Country:US
Practice Address - Phone:972-479-0400
Practice Address - Fax:972-479-9435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8525207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA67203Medicare UPIN
TX00936JMedicare PIN