Individual
MS. MARIE E. WEIDMAN-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6565 FANNIN ST # DB1-077, HOUSTON, TX 77030
(713) 441-4800
Mailing address
6565 FANNIN ST # DB1-077, HOUSTON, TX 77030-2703
(713) 441-4800
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
536615
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
AP110633
TX
363LW0102X
Women's Health Nurse Practitioner
536615
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467664557
BLUE CROSS BLUE SHIELD
TX
05
—
175916902
—
TX
05
—
TP1-175916901
—
TX
Enumeration date
05/03/2007
Last updated
03/04/2019
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