Individual
CHARLIE GLEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1500 CITYWEST BLVD STE 300, HOUSTON, TX 77042
(713) 620-4000
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
655560
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
075858
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075858
AANA
TX
01
—
622219
RN
TX
Enumeration date
01/30/2007
Last updated
07/15/2020
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