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NPI Code Detail

MEDICARE: BAHIYA JOHNSON

MEDICARE: BAHIYA JOHNSON
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
1372600000XAdult Companion00290481LA

General Provider Information

NPI Number : 1881130649
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAHIYA JOHNSON
Provider Business Mailing Address
First Line : 333 TEXAS ST STE 1300
Second Line :
City : SHREVEPORT
State : LA
Zip : 71101-3783
Country : US
Telephone Number : 318-618-0292
Fax Number :
Provider Business Practice Location Address
First Line : 333 TEXAS ST STE 1300
Second Line :
City : SHREVEPORT
State : LA
Zip : 71101-3783
Country : US
Telephone Number : 318-618-0292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2017
Last Update Date : 01/17/2017

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Directions to “ BAHIYA JOHNSON ” Practice Location

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