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General NPI Number Information
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NPI Number | 1548956873
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Entity Type | Individual
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Provider Name | AMY C JOHNSON MS, RD
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Gender | Female
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Dates
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Enumeration Date | 04/11/2023
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | NRG STADIUM TWO NRG PARK
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City | HOUSTON
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State | TX
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Zip | 77054
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Country | US
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Telephone | 832-544-1359
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Fax |
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Provider Business Mailing Address
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Address Line | 1744 1/2 W MAIN ST
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City | HOUSTON
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State | TX
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Zip | 77098-3608
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Country | US
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Telephone | 337-396-9785
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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 | 133VN1501X
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Taxonomy Name | Sports Dietetics Nutrition Registered Dietitian
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License Number | 86094557
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License Number State | LA
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