Provider Demographics
NPI:1962961409
Name:TJ FAMILY CLINIC PLLC
Entity type:Organization
Organization Name:TJ FAMILY CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:210-598-9191
Mailing Address - Street 1:3746 SCHERTZ PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-2929
Mailing Address - Country:US
Mailing Address - Phone:210-598-9191
Mailing Address - Fax:949-404-6521
Practice Address - Street 1:3746 SCHERTZ PKWY STE 100
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-2929
Practice Address - Country:US
Practice Address - Phone:210-598-9191
Practice Address - Fax:949-404-6521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care