| Organization Name: | JOHNSON & HAVENER MEDICAL SERVICES, PA |
| NPI Number: | 1003214859 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JERE M JOHNSON (PRESIDENT) |
| Mailing Address: | 1920 E Griffin Pkwy Mission |
| State: | TX US |
| Postal Code: | 785723106 |
| Phone Number: | 9565843353 |
| Fax Number: | 9565843253 |
| NPI Enumeration Date: | 12/10/2014 |
| NPI Last Update Date: | 12/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |