Individual
MS. AMY CHAPMAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030
(713) 792-6161
Mailing address
P O BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01712
TX
363AM0700X
Medical Physician Assistant
PA01712
TX
363AS0400X
Surgical Physician Assistant
PA01712
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
398399101
—
TX
01
—
398399102
CSHCN MEDICAID
TX
Enumeration date
06/12/2018
Last updated
07/29/2019
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