MEDICARE: DR. PLESHETTE B JOHNSON D.O.

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	111NR0400X	Rehabilitation Chiropractor	9316	TX

General Provider Information

NPI Number	:	1366584187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PLESHETTE B JOHNSON D.O.

Provider Business Mailing Address
First Line	:	1411 CROSS VALLEY DR
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-6934
Country	:	US
Telephone Number	:	281-451-3739
Fax Number	:	713-734-2394

Provider Business Practice Location Address
First Line	:	14455 CULLEN BLVD
Second Line	:	C-2
City	:	HOUSTON
State	:	TX
Zip	:	77047-4800
Country	:	US
Telephone Number	:	713-734-0700
Fax Number	:	713-734-2394

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	07/08/2007

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