Johnson, Brenda L
Johnson, Brenda L is an individual health care provider with primary practice located at 801 W Interstate 20 Ste 132 , Arlington TX 76017-5851. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Johnson, Brenda L can be contacted via phone (682) 274-8181.Contact Information
Primary practice address
801 W Interstate 20 Ste 132
Arlington TX 76017-5851
Phone: (682) 274-8181
Fax: (817) 764-0175
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA05858 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA05858 | Texas |
Profile Details
| NPI number | 1538319587 |
|---|---|
| LBN Legal business name | Johnson, Brenda L |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2008 |
| Last updated | Oct 12th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538319587 | NPPES |
| Texas | Other | 8100NR | BCBS |
| Texas | MEDICAID | 297908003 | BCBS |
| Texas | MEDICAID | 297908005 | BCBS |
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