Organization
ANITRA JOHNSON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITRA JOHNSON MD (MD OWNER)
(281) 333-3247
Entity
Organization
Contact information
Practice address
2060 SPACE PARK DR, SUITE 208, HOUSTON, TX 77058-3600
(281) 333-3247
(281) 333-9358
Mailing address
PO BOX 4346, DEPT 428, HOUSTON, TX 77210-4346
(713) 554-5300
(713) 554-5320
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M5253
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190762801
—
TX
Enumeration date
01/23/2008
Last updated
02/05/2009
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