MEDICARE: DIVINE HEALING HEALTHCARE, PLLC

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	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1598440968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIVINE HEALING HEALTHCARE, PLLC

Provider Business Mailing Address
First Line	:	8145 HWY 6 S
Second Line	:	SUITE 112 PMB 1026
City	:	HOUSTON
State	:	TX
Zip	:	77083
Country	:	US
Telephone Number	:	832-536-6055
Fax Number	:

Provider Business Practice Location Address
First Line	:	2225 COUNTY ROAD 90 STE 123
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-4891
Country	:	US
Telephone Number	:	832-536-6055
Fax Number	:	713-347-6924

Authorized Official
Title or Position	:	OWNER
Name	:	MARTHA L JOHNSON
Credential	:	FNP-C
Telephone Number	:	832-876-9673

Provider Enumeration Date	:	06/21/2023
Last Update Date	:	02/18/2026

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