Jack Johnson
Physician Assistant in Bastrop, TX. Individual provider (NPI-1).
NPI number1154075554
StatusActive
Last updated in NPPESFeb 5, 2022
Details
- NPI
- 1154075554
- Entity type
- Individual (NPI-1)
- Name
- Jack Johnson
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 5, 2022
- Certification date
- Feb 5, 2022
- Last updated
- Feb 5, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Practice location
212 Creek Loop RdBastrop, TX 78602-3197
Phone 512-988-6564
Mailing address
212 Creek Loop RdBastrop, TX 78602-3197
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.
Other Physician Assistant providers in Bastrop, TX
- Lance A Beahm, PA-CNPI 1912239690
- Carl Ronald Berg, PA-CNPI 1659396398
- Chara De'Andre Brown, PA-CNPI 1679891717
- Makenzie Marie Cook, PANPI 1427840354
- Dioscar J Delgado, PA-CNPI 1598397275
- Dawn Desimone, PA-CNPI 1588302533
- Alyssa Nicole Fanella, PA-CNPI 1619808268
- Thomas Michael Fields, PANPI 1346443900
- Jenna GrayNPI 1811770712
- Kamryn Janice Hassel, PANPI 1346044500
All 19 Physician Assistant providers in Bastrop · All 552 providers in Bastrop
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.