Gary Alan Johnson, P.T.

Primary specialty

SpecialistTaxonomy code 174400000X

License

1107241 Issued in TX

Practice address

1716 Briarcrest Dr
Ste 800
Bryan, TX 77802-2763

Phone

(979) 846-2878

Fax

(979) 846-2877

NPI assigned

Apr 4, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1992827802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 BRIARCREST DR",
            "address_2": "STE 800",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022763",
            "telephone_number": "979-846-2878",
            "fax_number": "979-846-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 BRIARCREST DR",
            "address_2": "STE 800",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022763",
            "telephone_number": "979-846-2878",
            "fax_number": "979-846-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GARY",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "1107241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BCBS P.T.",
            "identifier": "8T1220",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OUTPATIENT P.T.",
            "identifier": "0041JZ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1639130-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Insley John-Baptiste, RBT
• Johnson Dentistry Center, P.a.
• Brenda Johnson
• Drew A Johnson, D.C.
• Eva Patrice Johnson, MD
• Jacob Aaron Johnson, MSN, FNP-C
• Jacquelin Johnson, RSPS
• Jo Johnson
• John Albert Johnson Jr., D.D.S.
• Joycelyn Johnson

• Specialist in Bryan, TX
• Providers in Bryan, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.