Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 10918 | TX |
NPI | 1003051475 |
---|---|
Provider Name | Dr. Jason Paul Johnson |
First Address | Pearland, TX 77581-5671 |
Second Address | Pearland, TX 77581-5670 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2008 |
Last Update Date | 01/09/2016 |