Jack Johnson
Jack Johnson is a Physician Assistant in Bastrop, Texas. Practices as a sole proprietor. Registered with an NPI since 2022.
- In the registry since
- 2022
Practice location Address checks out
212 Creek Loop RdBastrop, TX 78602-3197
Phone: (512) 988-6564
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X |
|---|
Record details
| NPI number | 1154075554 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | February 5, 2022 |
| Last updated in NPPES | February 5, 2022 |
| Certification date | February 5, 2022 |
| Mailing address | 212 Creek Loop Rd, Bastrop, TX 78602-3197 |
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