Provider Demographics
NPI:1366584187
Name:JOHNSON, PLESHETTE B (DO)
Entity type:Individual
Prefix:DR
First Name:PLESHETTE
Middle Name:B
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1411 CROSS VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6934
Mailing Address - Country:US
Mailing Address - Phone:281-451-3739
Mailing Address - Fax:713-734-2394
Practice Address - Street 1:14455 CULLEN BLVD
Practice Address - Street 2:C-2
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-4800
Practice Address - Country:US
Practice Address - Phone:713-734-0700
Practice Address - Fax:713-734-2394
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9316111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU93334Medicare UPIN