Lakecrest Medical PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

H1113 Issued in TX

Legal business name

LAKECREST MEDICAL PLLC

Practice address

7617 Lakeview Pkwy
Rowlett, TX 75088-4356

Phone

(972) 475-1351

Fax

(972) 412-8220

NPI assigned

Sep 15, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Weldon R Johnson Jr., D.O.NPI 1063462331

Title

Physician

Phone

(972) 475-1351

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Weldon Johnson Jr, D.O. Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Weldon R. Johnson Jr., D.O.

  • Family Medicine Physician
  • Rowlett, TX
  • NPI 1063462331
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284508800000",
    "number": "1447568225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7617 LAKEVIEW PKWY",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750884356",
            "telephone_number": "972-475-1351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7617 LAKEVIEW PKWY",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750884356",
            "telephone_number": "972-475-1351",
            "fax_number": "972-412-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKECREST MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-09-15",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WELDON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "972-475-1351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H1113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0919714-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weldon Johnson Jr, D.O.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lake Pointe Partners, LTD.
• Lake Pointe Partners, LTD.
• Lake Pointe Pediatric Associates, P.a.
• Lake Pointe Radiology Associates PA
• Lake Ray Hubbard Pediatrics
• Lakeside Spine Center
• Lakeview Allergy & Asthma PA
• Lam Counseling Services PLLC
• Hung Minh Lam
• Stephanie A Lamb

• Family Medicine Physician in Rowlett, TX
• Providers in Rowlett, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.