Johnson, Jack

Johnson, Jack is an sole proprietor health care provider with primary practice located at 212 Creek Loop Rd , Bastrop TX 78602-3197. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Johnson, Jack can be contacted via phone (512) 988-6564.

Contact Information

Primary practice address
212 Creek Loop Rd Bastrop TX 78602-3197
Phone: (512) 988-6564
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1154075554
LBN Legal business name Johnson, Jack
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 5th, 2022
Last updated Feb 5th, 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.

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