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Carldale Johnson

NPI 1962863217 · on the registry since 2016 · sole proprietor

Practice

Address
1700 University Blvd
Apt. 224
Round Rock, TX 78665
Phone
(512) 659-1519
Organisation at this address
Royal Bluebird Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
5

Registry record

Primary taxonomy
343800000X
343800000X
Licence states on file
TX
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2016-03-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas