Ross, Johnny Shane

Ross, Johnny Shane is an individual health care provider with primary practice located at 2401 S 31St St Bldg 35 , Temple TX 76508-4200. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Ross, Johnny Shane can be contacted via phone (254) 724-2111.

Contact Information

Primary practice address
2401 S 31St St Bldg 35 Temple TX 76508-4200
Phone: (254) 724-2111
Fax: (512) 263-4506
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X J6036 Texas

Profile Details

NPI number 1104935030
LBN Legal business name Ross, Johnny Shane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Oct 23rd, 2024 - about 2 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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Identifiers

StateTypeNumberIssuer
All States NPI 1104935030 NPPES
Texas MEDICAID 0479743 02
Texas Other J6036
Texas Other 142726600

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