Most Relevant Information
Provider Data
| NPI Number: | 1003251539 |
| Provider Name: | MARY AGNES JOHNSON NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 834891 |
Most Important Dates
| Enumeration Date: | 05/10/2013 |
| Last Updated: | 05/10/2013 |
Provider Practice Location
1400 8TH AVE
FORT WORTH
TX
761044110
Practice Location Phone/Fax
| Phone: | 8179227070 |
| Fax: |
Provider Mailing Location
2900 WILLING AVE
FORT WORTH
TX
761103446
Provider Mailing Phone/Fax
| Phone: | 3347440554 |
| Fax: |