Doctor Name: | MR. ADRIAN R. JOHNSON |
NPI Number: | 1346512860 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW |
License Number: | |
Business Practice Address: | 3551 Roger Brooke Drive, Bldg 3528r Mche-dbm Fort Sam Houston, TX - 782346200 |
Business Phone Number: | 2105396330 |
Business Fax Number: | 2105395467 |
Mailing Address: | 3851 Roger Brooke Drive, Mche-qd (creds), FORT SAM HOUSTON |
State: | TX |
Postal Code: | 782346200 |
Phone Number: | 2109162460 |
Fax Number: | 2109165102 |
NPI Enumeration Date: | 01/30/2012 |
NPI Last Update Date: | 01/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |