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

MR. JACKIE GLEN JOHNSON

Active Sole Proprietor

MR. JACKIE GLEN JOHNSON is a Case Management Agency healthcare provider located in MIDLOTHIAN, Texas. NPI 1871130112 is currently active in the NPPES registry. Verify at CMS.

Case Management Agency · MIDLOTHIAN, TX

Registration Details

NPI Number
1871130112
Provider Type
Individual
Gender
Male
NPI Issued
Dec 5, 2019 (6.7273015328273 yrs)
Last Updated
Dec 5, 2019
Sole Proprietor
Yes

Practice Information

Address
434 ASHLAWN DR
MIDLOTHIAN, TX, 760655612
Browse TX providers · Browse ZIP 76065
Phone
8176095474
Fax
4696726069
Primary Specialty
Case Management Agency
251B00000X
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.