Most Relevant Information
Provider Data
| NPI Number: | 1003635038 |
| Provider Name: | CLOVER C JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 683034 |
Most Important Dates
| Enumeration Date: | 10/07/2024 |
| Last Updated: | 10/07/2024 |
Provider Practice Location
2201 N BEDELL AVE STE A
DEL RIO
TX
788408021
Practice Location Phone/Fax
| Phone: | 8307758700 |
| Fax: | 8307758711 |
Provider Mailing Location
2201 N BEDELL AVE STE A
DEL RIO
TX
788408021
Provider Mailing Phone/Fax
| Phone: | 8307758700 |
| Fax: | 8307758711 |