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General NPI Number Information
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NPI Number | 1982774212
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Entity Type | Organization
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Legal Business Name | PATRICIA J JOHNSON PHD & ASSOC PC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3722 NORTH MAIN
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City | BAYTOWN
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State | TX
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Zip | 77521
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Country | US
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Telephone | 281-428-7039
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Fax | 281-427-6252
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Provider Business Mailing Address
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Address Line | 3722 NORTH MAIN
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City | BAYTOWN
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State | TX
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Zip | 77521
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Country | US
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Telephone | 281-428-7039
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Fax | 281-427-6252
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Authorized Official
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Title or Position | CLINICAL NEUROPSYCHOLOGIST
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Name | DR. PATRICIA J JOHNSON
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Credential | PHD
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Telephone | 281-428-7039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 21628
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License Number State | TX
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