Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | K4472 | TX |
N | 208600000X | Surgeon | K4472 | TX |
Y | 2086S0129X | Vascular Surgeon | K4472 | TX |
NPI | 1114997186 |
---|---|
Provider Name | Dr. Johnna Kay Jones |
First Address | Fort Worth, TX 76104-2822 |
Second Address | Fort Worth, TX 76104-2822 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 22/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
154317504 | (05) | TX |
154317505 | (05) | TX |
H67047 | (02) | TX |