=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881881936
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANDREW F JOHNSON P.T.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2007
-----------------------------------------------------
Last Update Date | 10/02/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10907 I-10 EAST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77029-1911
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-533-5400
-----------------------------------------------------
Fax | 281-674-3081
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10907 I-10 EAST
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77029-1911
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-533-5400
-----------------------------------------------------
Fax | 281-674-3081
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2251X0800X
-----------------------------------------------------
Taxonomy Name | Orthopedic Physical Therapist
-----------------------------------------------------
License Number | 1120871
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------