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General NPI Number Information
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NPI Number | 1386243434
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Entity Type | Individual
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Provider Name | ISAIAH T JOHNSON
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Gender | Male
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 1212 COLUMBIA ST
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City | HOUSTON
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State | TX
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Zip | 77008-7012
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Country | US
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Telephone | 713-203-0787
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Fax |
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Provider Business Mailing Address
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Address Line | 3006 HAVERLING DR
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City | PEARLAND
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State | TX
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Zip | 77584-9159
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Country | US
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Telephone | 281-536-0006
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1338174
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License Number State | TX
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