Marcos Salvador Johnson, CSFA, LSA
Individual provider Active NPI Surgical Assistant · Bulverde, TX
NPI 1407200819 · NPPES record last updated Apr 20, 2020
Key facts
- NPI
- 1407200819
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Assistant 246ZC0007X
- Practice address
- 29523 Copper Xing
Bulverde, TX 78163-2488 - Phone
- (361) 779-2443
- NPI assigned
- Apr 21, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | Yes |
Addresses
Primary practice location
29523 Copper Xing
Bulverde, TX 78163-2488
Mailing address
29523 Copper Xing
Bulverde, TX 78163-2488
Phone (361) 779-2443
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SA00732 | Other | TX | TMB |
Other providers in Bulverde, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.