David Johnson IV, MD
Military Health Care Provider in Fort Bliss, TX. Individual provider (NPI-1).
NPI number1104614833
StatusActive
Last updated in NPPESFeb 11, 2026
Details
- NPI
- 1104614833
- Entity type
- Individual (NPI-1)
- Name
- David Johnson IV
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 30, 2025
- Certification date
- Feb 11, 2026
- Last updated
- Feb 11, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171000000X | Military Health Care Provider | – | TX | Yes |
Practice location
18511 Highlander Medics StFort Bliss, TX 79906-5327
Phone 317-208-0416
Mailing address
18511 Highlander Medics StFort Bliss, TX 79906-5327
Phone 317-208-0416
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 55 Military Health Care Provider providers in Fort Bliss · All 580 providers in Fort Bliss
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