MR. Jackie Glen Johnson
NPI #1871130112 in Midlothian, Texas
Provider Information
- NPI Number
- 1871130112
- Entity Type
- Individual
- Name
- MR. Jackie Glen Johnson
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Case Management
- Enumeration Date
- Dec 5, 2019
- Last Updated
- Dec 5, 2019
Practice Location
- Address
- 434 ASHLAWN DR
- City
- Midlothian
- State
- Texas
- ZIP Code
- 76065-5612
- Phone
- (817) 609-5474
Specialties & Taxonomy Codes
| Specialty |
|---|
| Case Management |
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