Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

EDDIE JOHNSON

Active Sole Proprietor

Intellectual Disabilities Residential Treatment Facility · LONE STAR, TX

Registration Details

NPI Number: 1134630957
Provider Type: Individual
Gender: Male
NPI Issued: Oct 19, 2017 (8.505968667118 yrs)
Last Updated: Oct 19, 2017
Sole Proprietor: Yes

Practice Information

Address: 338 BOND ST

LONE STAR, TX, 756680230
Browse TX providers · Browse ZIP 75668
Phone: 9036463171
Fax: 9036460512
Primary Specialty: Intellectual Disabilities Residential Treatment Facility
320600000X

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.