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General NPI Number Information
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NPI Number | 1255545182
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Entity Type | Organization
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Legal Business Name | TOTAL HEALTH FAMILY MEDICAL GROUP
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 10905 MEMORIAL HERMANN DR SUITE 113
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City | PEARLAND
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State | TX
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Zip | 77584-3490
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Country | US
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Telephone | 832-775-1042
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Fax | 713-340-0481
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Provider Business Mailing Address
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Address Line | 10905 MEMORIAL HERMANN DR SUITE 113
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City | PEARLAND
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State | TX
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Zip | 77584-3490
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Country | US
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Telephone | 832-775-1042
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Fax | 713-340-0481
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. SHAWN R JOHNSON
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Credential | M.D.
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Telephone | 901-283-8579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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