MEDICARE: ANITRA LYNNE 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	207V00000X	Obstetrics & Gynecology Physician	M5253	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
2	0013QR	OTHER	TX	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497806699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITRA LYNNE JOHNSON M.D.

Provider Business Mailing Address
First Line	:	3314 TIMBERGROVE HEIGHTS ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-6471
Country	:	US
Telephone Number	:	281-467-3997
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BAYLOR PLZ
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-3411
Country	:	US
Telephone Number	:	281-467-3997
Fax Number	:

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

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	05/18/2026

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