Provider Demographics
NPI:1730856733
Name:CALDWELL-JOHNSON PLLC
Entity type:Organization
Organization Name:CALDWELL-JOHNSON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:254-715-3166
Mailing Address - Street 1:210 E AVE J
Mailing Address - Street 2:BLDG 1
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-5892
Mailing Address - Country:US
Mailing Address - Phone:254-803-3561
Mailing Address - Fax:847-221-6940
Practice Address - Street 1:210 E AVE J
Practice Address - Street 2:BLDG 1
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-5892
Practice Address - Country:US
Practice Address - Phone:254-803-3561
Practice Address - Fax:847-221-6940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center