Raymond Louis Johnson, IDC
Individual provider Active NPI Independent Duty Corpsman · Ingleside, TX
NPI 1871787614 · NPPES record last updated Sep 5, 2007
Key facts
- NPI
- 1871787614
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Corpsman 1710I1002X
- Practice address
- 327 Coral Sea Rd
Suite 165
Ingleside, TX 78362-5055 - Phone
- (361) 776-1374
- Fax
- (361) 776-1103
- NPI assigned
- Sep 5, 2007
- Sex
- Male
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Corpsman | 1710I1002X | Yes |
Addresses
Primary practice location
327 Coral Sea Rd
Suite 165
Ingleside, TX 78362-5055
Mailing address
327 Coral Sea Rd
Suite 165
Ingleside, TX 78362-5055
Phone (361) 776-1374
Other providers in Ingleside, TX
- Ingleside Dentistry
- Ingleside Medical & Aesthetics PLLC
- Inglesie Isd
- Lupita Jasso
- Jerry'S Pharmacy, LTD
- Dwayne A Kubecka
- Patti J Licona
- Damian J Lovello
- Mayfield Chiropractic
- Idana Merrick
All providers in Ingleside, TX · Independent Duty Corpsman in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2007. 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.