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

JACK JOHNSON

Active Sole Proprietor

JACK JOHNSON is a Physician Assistant healthcare provider located in BASTROP, Texas. NPI 1154075554 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · BASTROP, TX

Registration Details

NPI Number
1154075554
Provider Type
Individual
Gender
Male
NPI Issued
Feb 5, 2022 (4.3382913281076 yrs)
Last Updated
Feb 5, 2022
Sole Proprietor
Yes

Practice Information

Address
212 CREEK LOOP RD
BASTROP, TX, 786023197
Browse TX providers · Browse ZIP 78602
Phone
5129886564
Primary Specialty
Physician Assistant
363A00000X

Other Physician Assistant Providers in BASTROP, TX

Name Credential NPI
CARL RONALD BERG PA-C 1659396398
JOHN ANDREW SANDOVAL PA-C 1952424368
THOMAS MICHAEL FIELDS PA 1346443900
LANCE A BEAHM PA-C 1912239690
MS. CHARA DE'ANDRE BROWN PA-C 1679891717
MR. JOSE MANUEL PEREZ II PA-C 1578963450
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.