MEDICARE: TARA M JOHNSTON AUD

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	231H00000X	Audiologist	51343	TX

General Provider Information

NPI Number	:	1558352088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA M JOHNSTON AUD

Provider Business Mailing Address
First Line	:	1860 FM 359 RD
Second Line	:	# 324
City	:	RICHMOND
State	:	TX
Zip	:	77406-1296
Country	:	US
Telephone Number	:	979-250-1335
Fax Number	:

Provider Business Practice Location Address
First Line	:	1856 FM 359 RD
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-1296
Country	:	US
Telephone Number	:	866-714-7495
Fax Number	:	979-383-2292

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

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	08/17/2023

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Directions to “ TARA M JOHNSTON AUD” Practice Location

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