12221 MERIT DR SUITE 1610
DALLAS, TX 75251-2202 US PECOS Enrolled
Overview
Frederick C Johnson is a Pediatrician in the DALLAS area. Frederick C Johnson primary office location is at 12221 MERIT DR and new patients are welcome to contact this healthcare provider for an appointment. The NPI number is 1205851672 and the information was updated approximately 11 years ago.
We have not detected any Exclusions tied directly to this NPI.
Accepts Medicare Assignment: Unknown
Is sole proprietor: NO
Participates in PECOS: YES (See any PECOS details below)
Contact Information
| License Number | State |
|---|---|
| L4474 | TX |
| Type/Issuer | Identifier | State |
|---|---|---|
| BCBS | 8S2689 | TX |
| MEDICAID | 164307406 | TX |
| MEDICAID | 23981741 | NM |
| MEDICAID | 164307403 | TX |
| MEDICAID | 164307404 | TX |
| Taxonomy | State | Primary? |
|---|---|---|
| Pediatrician - Taxonomy Code 208000000X | TX | Y |
| Pediatrician (Emergency Medicine) - Taxonomy Code 2080P0204X | TX | N |
PECOS Details:
| Participates in PECOS: | YES |
| PECOS Individual Enrollment ID: | |
| PECOS Individual PAC ID: | |
| Eligible to order/refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible to order/refer Durable Medical Equipment (DME) | Yes |
| Eligible to order/refer Home Health Agency (HHA) | Yes |
| Eligible to order/refer Power Mobility Devices (PMD) | Yes |
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