Provider Demographics
NPI:1740663467
Name:JOHNSON, KATRINA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 IRISH CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-3507
Mailing Address - Country:US
Mailing Address - Phone:225-247-9292
Mailing Address - Fax:
Practice Address - Street 1:3810 FM 3009
Practice Address - Street 2:WALGREENS
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154
Practice Address - Country:US
Practice Address - Phone:210-566-3245
Practice Address - Fax:210-566-8834
Is Sole Proprietor?:No
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist