Karen Johnson

Individual provider Active NPI Other Technician · Groesbeck, TX

NPI 1700139136 · NPPES record last updated Oct 23, 2012

Key facts

NPI
1700139136
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
Practice address
204 W Trinity St
Groesbeck, TX 76642-1324
Phone
(254) 729-3740
Fax
(254) 729-8760
NPI assigned
Oct 23, 2012
Sex
Female
Sole proprietor
Yes

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)CodeLicenseStatePrimary
Other Technician 247200000X Yes

Addresses

Primary practice location

204 W Trinity St
Groesbeck, TX 76642-1324

Mailing address

PO Box 131
Groesbeck, TX 76642-0131
Phone (254) 729-3740

Other providers in Groesbeck, TX

All providers in Groesbeck, TX · Other Technician in Texas

Sources for this page

Verify at the official NPI Registry.