KEONDRA C JOHNSON NPI 1578179750

NPI Information

NPI: 1578179750
Provider Name: KEONDRA C JOHNSON
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Individual
Address:
2140 MEDICAL DISTRICT DR APT 2052
DALLAS, TX
ZIP 75235
Phone: (214) 695-4955
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Keondra C Johnson is an intermediate care facility mentally retarded in Dallas, TX. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. Keondra C Johnson NPI is 1578179750. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2140 MEDICAL DISTRICT DR APT 2052
DALLAS, TX
ZIP 75235-097
Phone: (214) 695-4955

The enumeration date for this NPI number is 9/22/2020 and was last updated on 9/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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