Individual
GLOVER O.L. JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
138 ELDRIDGE RD, STE E, SUGAR LAND, TX 77478-4083
(713) 234-7390
(713) 234-7336
Mailing address
10906 OLYMPIA DR, HOUSTON, TX 77042-2629
(713) 234-7390
(713) 234-7336
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
E2031
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10019729
AMERIGROUP
TX
05
—
131117704
—
TX
05
—
131117707
—
TX
01
—
1565261
LOUSIANA MEDICAID
TX
01
—
183097000
TEXAS WORKER'S COMP
TX
01
—
4010529
AETNA
TX
01
—
609573
UNITED HEALTHCARE
TX
01
—
8H9486
BCBS
TX
01
—
N504748
WELLCARE
TX
Enumeration date
02/27/2006
Last updated
12/03/2015
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