Organization
SPACE CITY MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON L JOHNSON FNP (NURSE PRACTITIONER)
(832) 549-6655
Entity
Organization
Contact information
Practice address
7401 GLEASON RD, HOUSTON, TX 77016-2708
(832) 549-6655
Mailing address
7401 GLEASON RD, HOUSTON, TX 77016-2708
(832) 549-6655
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/03/2021
Last updated
01/03/2021
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