Individual
MARUJA ELVIRA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12371 S KIRKWOOD RD, STAFFORD, TX 77477-2836
(713) 995-9292
Mailing address
12371 S KIRKWOOD RD, STAFFORD, TX 77477-2836
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
209650
NC
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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