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General NPI Number Information
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NPI Number | 1598754194
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Entity Type | Individual
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Provider Name | SHAWN R JOHNSON MD
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Gender | Female
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 2734 SUNRISE BLVD SUITE 404
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City | PEARLAND
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State | TX
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Zip | 77584-8514
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Country | US
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Telephone | 713-436-4007
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Fax | 713-340-0481
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Provider Business Mailing Address
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Address Line | PO BOX 841526
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City | PEARLAND
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State | TX
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Zip | 77584-0075
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Country | US
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Telephone | 713-436-7023
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Fax | 713-340-0481
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 17735
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K8919
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License Number State | TX
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