Healthcare Provider Details

I. General information

NPI: 1538076708
Provider Name (Legal Business Name): MAYA SONOI JOHNSON AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W HARWOOD RD
HURST TX
76054-3058
US

IV. Provider business mailing address

5303 50TH ST
LUBBOCK TX
79414-1817
US

V. Phone/Fax

Practice location:
  • Phone: 817-280-9632
  • Fax: 806-785-4327
Mailing address:
  • Phone: 806-702-8208
  • Fax: 806-785-4327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number82053
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: