MEDICARE: DR. JENNIFER JOHNSON-CALDWELL, M.D.,P.A.

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
1	207R00000X	Internal Medicine Physician		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366449357
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. JENNIFER JOHNSON-CALDWELL, M.D.,P.A.

Provider Business Mailing Address
First Line	:	2450 LOUISIANA ST
Second Line	:	STE 400716
City	:	HOUSTON
State	:	TX
Zip	:	77006-2380
Country	:	US
Telephone Number	:	713-520-8963
Fax Number	:	713-523-6941

Provider Business Practice Location Address
First Line	:	1315 ST JOSEPH PKWY
Second Line	:	STE 140
City	:	HOUSTON
State	:	TX
Zip	:	77002-8233
Country	:	US
Telephone Number	:	713-520-8963
Fax Number	:	713-523-6941

Authorized Official
Title or Position	:	INTERNAL MEDICINE
Name	:	JENNIFER LAVETTE JOHNSON-CALDWELL
Credential	:	MD
Telephone Number	:	713-520-8963

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	07/21/2022

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