| Bryan Johnson, RD | |
|
771 E Southlake Blvd Ste 106, Southlake, TX 76092-6354 | |
| (469) 372-2022 | |
| (833) 290-5413 |
| Full Name | Bryan Johnson |
|---|---|
| Gender | Male |
| Speciality | Registered Dietitian Or Nutrition Professional |
| Experience | 2 Years |
| Location | 771 E Southlake Blvd Ste 106, Southlake, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306641220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | DT91917 (Texas) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Doherty Nutrition Llc | 0941610273 | 16 |
| Provider Name | Doherty Nutrition LLC |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1326502832 PECOS PAC ID: 0941610273 Enrollment ID: O20201028000071 |
| Mailing Address | Practice Location Address |
|---|---|
| Bryan Johnson, RD 17060 Dallas Pkwy Ste 112, Dallas, TX 75248-1905 Ph: (469) 372-2022 | Bryan Johnson, RD 771 E Southlake Blvd Ste 106, Southlake, TX 76092-6354 Ph: (469) 372-2022 |
Jessica Julstedt Coffee, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1209 Timber Ct, Southlake, TX 76092 Phone: 817-366-4643 |
Mrs. Kara (rae) Rae Boswell, MS, RD, LD Dietitian Medicare: Medicare Enrolled Practice Location: 630 N Kimball Ave Ste 110, Southlake, TX 76092 Phone: 972-422-9180 |
Janice May, RDN, LD, CDE Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1047 Summerplace Ln, Southlake, TX 76092 Phone: 817-905-7722 |
Mary Wilson, RD Dietitian Medicare: Medicare Enrolled Practice Location: 620 E Southlake Blvd, Southlake, TX 76092 Phone: 214-623-6270 |
Anne-marie Alford, RD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 771 E Southlake Blvd Ste 106, Southlake, TX 76092 Phone: 469-372-2022 Fax: 833-290-5413 |
Dana Dodge, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 411 Osprey Ct, Southlake, TX 76092 Phone: 925-548-5440 |
Natalie Blayke Anderson, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 401 N Carroll Ave # 179, Southlake, TX 76092 Phone: 214-517-7155 |