Organization
NON-INVASIVE CARDIOVASCULAR PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLOVER O.L. JOHNSON JR. M.D. (PRESIDENT)
(713) 234-7390
Entity
Organization
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
—
0064KB
BCBS GROUP
TX
01
—
01209859
AMERIGROUP
TX
05
—
167319601
—
TX
01
—
2354224
AETNA
TX
01
—
DA1201
MEDICARE RAILROAD
TX
Enumeration date
12/12/2006
Last updated
12/03/2015
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