Roel Mario Johnson, APT
Technician, Other in Tyler, TX. Individual provider (NPI-1).
NPI number1912290099
StatusActive
Last updated in NPPESMay 23, 2011
Details
- NPI
- 1912290099
- Entity type
- Individual (NPI-1)
- Name
- Mr. Roel Mario Johnson
- Credential
- APT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 23, 2011
- Last updated
- May 23, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | 00965268 | TX | Yes |
| 225CA2400X | Rehabilitation Counselor, Assistive Technology Practitioner | 00965268 | TX |
Practice location
805 N Glenwood BlvdTyler, TX 75702-5033
Phone 903-509-0800 · Fax 903-509-0803
Mailing address
805 N Glenwood BlvdTyler, TX 75702-5033
Phone 903-509-0800 · Fax 903-509-0803
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