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Organization

WM. KENT JOHNSON, M.D., F.A.C.S., P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROSIE VAILES (SECRETARY)
(281) 893-2288
Entity
Organization

Contact information

Practice address
17203 RED OAK DR STE 103, HOUSTON, TX 77090-2612
(281) 893-2288
(281) 893-2882
Mailing address
17203 RED OAK DR STE 103, HOUSTON, TX 77090-2612
(281) 893-2288
(281) 893-2882

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
H6320
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00662G
MEDICARE ID
TX
Enumeration date
04/22/2008
Last updated
04/22/2008
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