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JACK JOHNSON
NPI 1154075554
Physician Assistant in Bastrop, TX

Active since February 05, 2022
212 CREEK LOOP RD, BASTROP, TX 78602(512) 988-6564 Get Directions Write a Review

NPPES record last updated: February 5, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jack Johnson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK JOHNSON (NPI 1154075554) is an individual physician assistant in Bastrop, Texas and active in the NPI registry since February 2022.

NPPES Registry Identity

NPI1154075554
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameJACK JOHNSON
Location Address212 CREEK LOOP RDBastrop, TX 78602-3197
Mailing Address212 Creek Loop RdBastrop, TX 78602-3197
Phone(512) 988-6564
Sole ProprietorYes
Enumeration DateFebruary 5, 2022
NPPES CertifiedFebruary 5, 2022
✔ NPI 1154075554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
212 CREEK LOOP RD, Bastrop, TX 78602
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Johnson's NPI number?

The NPI number for Jack Johnson is 1154075554. It was assigned to this individual provider in the NPPES registry on February 5, 2022.

Where is Jack Johnson located?

Jack Johnson practices at 212 Creek Loop Rd, Bastrop, TX 78602. The listed phone number is (512) 988-6564.

What is Jack Johnson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

When was this NPI record last updated?

The NPPES record for Jack Johnson was last updated on February 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.