MEDICARE: ERIK SCOTT JOHNSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	L4990	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164409355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIK SCOTT JOHNSON M.D.

Provider Business Mailing Address
First Line	:	1331 NORTHPARK DR
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77339-1636
Country	:	US
Telephone Number	:	281-359-5330
Fax Number	:

Provider Business Practice Location Address
First Line	:	15881 FM 529 RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-2577
Country	:	US
Telephone Number	:	713-461-2915
Fax Number	:	713-461-5307

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	09/07/2022

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