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1053320218
JACKIE RAY JOHNSON
DALLAS, TX
NPI
1053320218
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: TX 510698)
Enumeration Date
2006-08-05
Last Update Date
2009-11-18
Business Address
Mr. JACKIE RAY JOHNSON CRNA
8200 WALNUT HILL LN
DALLAS, TX 75231-4426
Phone number: 214-345-7175
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Mailing Address
Mr. JACKIE RAY JOHNSON CRNA
3008 SHILLING RD
TEXARKANA, TX 75503-5423
Phone number: 903-792-2173
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