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NPI Code Detail

MEDICARE: MRS. VIVIAN MAXINE JOHNSON PHARMACIST

MEDICARE: MRS. VIVIAN MAXINE JOHNSON PHARMACIST
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
1183500000XPharmacist19773TX

General Provider Information

NPI Number : 1306121819
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. VIVIAN MAXINE JOHNSON PHARMACIST
Provider Business Mailing Address
First Line : 3822 OLD SPANISH TRL
Second Line :
City : HOUSTON
State : TX
Zip : 77021-1340
Country : US
Telephone Number : 713-741-7323
Fax Number : 713-741-3166
Provider Business Practice Location Address
First Line : 3822 OLD SPANISH TRL
Second Line :
City : HOUSTON
State : TX
Zip : 77021-1340
Country : US
Telephone Number : 713-741-7323
Fax Number : 713-741-3166
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2011
Last Update Date : 10/15/2011

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