Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 9316 | TX |
NPI | 1366584187 |
---|---|
Provider Name | Dr. Pleshette B Johnson |
First Address | Sugar Land, TX 77479-6934 |
Second Address | Houston, TX 77047-4800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U93334 | (02) | TX |