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NPI Code Detail

MEDICARE: KYERA JOHNSON

MEDICARE:   KYERA  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
1224P00000XProsthetist

General Provider Information

NPI Number : 1922631043
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYERA JOHNSON
Provider Business Mailing Address
First Line : 5619 ALDINE BENDER RD APT 275B
Second Line :
City : HOUSTON
State : TX
Zip : 77032-4506
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5619 ALDINE BENDER RD APT 275B
Second Line :
City : HOUSTON
State : TX
Zip : 77032-4506
Country : US
Telephone Number : 469-285-2886
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2020
Last Update Date : 02/17/2020

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Directions to “ KYERA JOHNSON ” Practice Location

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