Healthcare Provider Details

I. General information

NPI: 1164682381
Provider Name (Legal Business Name): JOHANNA LEIGH MORTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W 38TH ST SUITE 308
AUSTIN TX
78731-6400
US

IV. Provider business mailing address

1600 W 38TH ST SUITE 308
AUSTIN TX
78731-6400
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-3540
  • Fax:
Mailing address:
  • Phone: 512-324-3540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number036142479
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number036142479
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberP3393
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: