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NPI 1376747196
● Active Type 2 · Organization
J. David Johnson,md,pa
Specialist · Tyler, TX · NPI 1376747196
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Enumerated 2007 · 18 years on NPI
J. David Johnson,md,pa is 1 of 4038 specialist organizations in Texas.
NPI age
18 years
Enumerated 2007-06-14
Primary specialty
Specialist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Gordon
Ofc Mgr
Last NPPES update
2008-01-28
Source: monthly bulk 2026-05
How this organization compares
Across 4038 active specialist providers in Texas.
NPI age
18 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
NPI lifetime · 2007 → 2026
2007-06 Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
618 S Broadway Ave
Tyler, TX 757011665
📞 9035969900 fax 9035960242
Mailing address
618 S Broadway Ave
Tyler, TX 757011665
📞 9035969900 fax 9035960242
Authorized official
James M Gordon, NURSE PRACTITIONER
Ofc Mgr
📞 9035969900
Individual providers at this organization
3 individual providers on file at this primary practice address.
Specialties
Specialist
Primary
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
TX license #G7829 TX license #K4497 taxonomy 174400000X
Identifiers
Type Value Notes
05 (TX)
128264203
Practice context
Multi-provider organization.
3 individual providers on file at this primary address.
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How to verify this organization
Confirm the NPI on NPPES. The CMS registry is the system of record. Open NPPES →
Verify the organization is in good standing. Cross-check with the state's business registration and any applicable licensing boards.
Confirm payer enrollment if billing. NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.
Updated 2026-05-14
· Source: CMS NPPES bulk export. Praxis MD refreshes the directory monthly with weekly delta updates.
Independent public resource. Not affiliated with CMS, HHS, or NPPES. Not endorsed by the U.S. government.
NPI listing is not proof of active licensure or payer enrollment.