Healthcare Provider Details

I. General information

NPI: 1891478038
Provider Name (Legal Business Name): BRANDON ASANTE JOHNSON PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 QUEBEC ST STE 8200
DENVER CO
80207-2345
US

IV. Provider business mailing address

1300 W SAM HOUSTON PKWY S STE 300
HOUSTON TX
77042-2453
US

V. Phone/Fax

Practice location:
  • Phone: 303-322-4900
  • Fax: 303-322-4909
Mailing address:
  • Phone: 303-322-4900
  • Fax: 303-322-4909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTL.0019197
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: