MEDICARE: ROBERT L JOHNSON III

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1932951522	TX

General Provider Information

NPI Number	:	1568390540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT L JOHNSON III

Provider Business Mailing Address
First Line	:	7108 WESTLEA LN # A
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7865
Country	:	US
Telephone Number	:	832-776-4488
Fax Number	:

Provider Business Practice Location Address
First Line	:	9896 BISSONNET ST STE 510
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-8156
Country	:	US
Telephone Number	:	832-776-4488
Fax Number	:

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

Provider Enumeration Date	:	05/11/2026
Last Update Date	:	05/11/2026

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