MEDICARE: SHAWN EVETTE 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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	P3902	TX
2	207X00000X	Orthopaedic Surgery Physician	P3902	TX
3	207X00000X	Orthopaedic Surgery Physician	23310	NE
4	207X00000X	Orthopaedic Surgery Physician	0101252896	VA
5	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	MD.205784	LA

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609927342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN EVETTE JOHNSON M.D.

Provider Business Mailing Address
First Line	:	23390 PLANTATION LAKE DR
Second Line	:
City	:	HEMPSTEAD
State	:	TX
Zip	:	77445-8013
Country	:	US
Telephone Number	:	936-463-1913
Fax Number	:	936-873-8647

Provider Business Practice Location Address
First Line	:	3720 WESTHEIMER RD STE 601
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-5277
Country	:	US
Telephone Number	:	936-463-1913
Fax Number	:	936-873-8647

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	03/29/2025

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Directions to “ SHAWN EVETTE JOHNSON M.D.” Practice Location

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