Individual
CULLEN JOHNSON ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RSPS, MHPS, PSS
Contact information
Practice address
12301 MAIN ST, HOUSTON, TX 77035-6207
(713) 275-5115
Mailing address
PO BOX 524132, HOUSTON, TX 77052-4132
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1271-0621
TX
175T00000X
Peer Specialist
50028-0820
TX
Other
Enumeration date
10/22/2019
Last updated
01/28/2024
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