MEDICARE: CHRISTINE SOLVEIG 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	390200000X	Student in an Organized Health Care Education/Training Program	RS2013-0377	NM
2	207R00000X	Internal Medicine Physician	R3689	TX

General Provider Information

NPI Number	:	1215370929
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE SOLVEIG JOHNSON M.D.

Provider Business Mailing Address
First Line	:	9417 MESA DR STE A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77028-1253
Country	:	US
Telephone Number	:	713-848-7780
Fax Number	:	833-710-0641

Provider Business Practice Location Address
First Line	:	9417 MESA DR STE A
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77028-1253
Country	:	US
Telephone Number	:	713-848-7780
Fax Number	:	833-710-0641

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

Provider Enumeration Date	:	04/11/2013
Last Update Date	:	12/14/2021

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