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NPI 1871787614

IndividualActive

Raymond Johnson, IDC

NPI 1871787614 · Independent Duty Corpsman · Ingleside, TX

Provider details

NPI number: 1871787614
Entity type: Individual
Primary specialty: Independent Duty CorpsmanOther Service Providers
Credential: IDC
Sex: Male
Sole proprietor: Yes

Practice location

327 Coral Sea Rd

Suite 165

Ingleside, TX 78362-5055

Phone: (361) 776-1374

Fax: (361) 776-1103

More TX providers

Mailing address

327 Coral Sea Rd

Ingleside, TX 78362-5055

Registry dates

Enumerated: 2007-09-05
Last updated: 2007-09-05

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Raymond Johnson, IDC — NPI 1871787614, Ingleside, TX | NPI Central