Healthcare Provider Details

I. General information

NPI: 1457371528
Provider Name (Legal Business Name): BRANDON D. JOHNSON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9410 FM 1960 RD W
HOUSTON TX
77070-6211
US

IV. Provider business mailing address

21507 EAST GOLD BUTTERCUP CT.
CYPRESS TX
77433-3513
US

V. Phone/Fax

Practice location:
  • Phone: 281-890-4828
  • Fax: 281-890-7721
Mailing address:
  • Phone: 281-304-0640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number9360
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: