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NPI Code Detail

MEDICARE: RITA JOHNSON

MEDICARE: RITA JOHNSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1156FX1800XOptician141085TX

General Provider Information

NPI Number : 1053252221
Entity Type Code : Individual
Provider Name (Legal Business Name) : RITA JOHNSON
Provider Business Mailing Address
First Line : 2301 E WACO DR
Second Line :
City : WACO
State : TX
Zip : 76705-3207
Country : US
Telephone Number : 254-412-1700
Fax Number : 254-412-1780
Provider Business Practice Location Address
First Line : 2301 E WACO DR
Second Line :
City : WACO
State : TX
Zip : 76705-3207
Country : US
Telephone Number : 254-412-1700
Fax Number : 254-412-1780
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2026
Last Update Date : 04/02/2026

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Directions to “ RITA JOHNSON ” Practice Location

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