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Larry Johnson SR.
Private Vehicle in Waco, Texas
NPI 1093103491

Larry Johnson SR. is a Private Vehicle based in Waco, TX. Larry Johnson SR. practices in Waco, TX. The NPI Number for Larry Johnson SR. is 1093103491 and holds a License No. 36634675 (Texas).

The current practice location address for Larry Johnson SR. is 600 Lake Air Dr, Waco, TX and can be reached out via phone at 254-224-6208. You can also correspond with Larry Johnson SR. through the mailing address at 600 LAKE AIR DR, WACO, TX - 76710-5887 (mailing address contact number: 254-224-6208).

Location: 600 Lake Air Dr, Waco, TX, 76710-5887
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1093103491
Provider Name
Larry Johnson SR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
600 Lake Air Dr, Waco, TX, 76710-5887
Phone Number
254-224-6208
Fax Number
Provider Enumeration Date
01/07/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
600 Lake Air Dr
City
Waco
State
Texas
Zip
76710-5887
Phone Number
254-224-6208
Fax Number
person
Provider Business Mailing Address Details
Address
600 Lake Air Dr
City
Waco
State
Texas
Zip
76710-5887
Phone Number
254-224-6208
Fax Number
person
Provider's Taxonomy Details 1
Type
Transportation Services
Classification
Private Vehicle
Speciality
-
Taxonomy
347C00000X
License No.
36634675 (Texas)
Definition
An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
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