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NPI Code Detail

MEDICARE: DR. KATANDRIA JOHNSON DRPH

MEDICARE:  DR. KATANDRIA  JOHNSON  DRPH
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
1235Z00000XSpeech-Language Pathologist101206

General Provider Information

NPI Number : 1790135200
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATANDRIA JOHNSON DRPH
Provider Business Mailing Address
First Line : 400 BLUFF CT
Second Line :
City : CEDAR HILL
State : TX
Zip : 75104-6726
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 400 BLUFF CT
Second Line :
City : CEDAR HILL
State : TX
Zip : 75104-6726
Country : US
Telephone Number : 817-825-4001
Fax Number : 817-288-0650
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2016
Last Update Date : 06/15/2016

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Directions to “ DR. KATANDRIA JOHNSON DRPH” Practice Location

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