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General NPI Number Information
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NPI Number | 1295368405
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Entity Type | Individual
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Provider Name | JOSHUA ALEX JOHNSON
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Gender | Male
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Dates
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Enumeration Date | 02/16/2020
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 4007 WOODLAWN AVE
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City | PASADENA
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State | TX
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Zip | 77504-1910
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Country | US
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Telephone | 713-944-0864
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Fax |
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Provider Business Mailing Address
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Address Line | 9811 JOYCE DR
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City | ROSHARON
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State | TX
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Zip | 77583-2691
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Country | US
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Telephone | 972-804-8124
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 37513
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License Number State | TX
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