Provider Demographics
NPI:1982110573
Name:JOHNES & GERALD, LLC
Entity Type:Organization
Organization Name:JOHNES & GERALD, LLC
Other - Org Name:BETHEL GARDEN PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PMHNP-BC; OWNER/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNES
Authorized Official - Middle Name:BOGONKO
Authorized Official - Last Name:MONYONCHO
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:469-951-0649
Mailing Address - Street 1:1229 E PLEASANT RUN RD STE 128
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4211
Mailing Address - Country:US
Mailing Address - Phone:972-639-8144
Mailing Address - Fax:
Practice Address - Street 1:1229 E PLEASANT RUN RD STE 128
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4211
Practice Address - Country:US
Practice Address - Phone:972-639-8144
Practice Address - Fax:972-692-8379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP122703363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty