Premila Johnson, Md Lp | |
2300 W Michigan Ave Suite 5 Midland TX 79701-5808 | |
(432) 413-5496 | |
Not Available |
Full Name | Premila Johnson, Md Lp |
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Speciality | Internal Medicine |
Location | 2300 W Michigan Ave, Midland, Texas |
Authorized Official Name and Position | Premila Lakshmi Singh Johnson (PHYSICIAN/OWNER) |
Authorized Official Contact | 4324135496 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Premila Johnson, Md Lp 2300 W Michigan Ave Suite 5 Midland TX 79701-5808 Ph: () - | Premila Johnson, Md Lp 2300 W Michigan Ave Suite 5 Midland TX 79701-5808 Ph: (432) 413-5496 |
NPI Number | 1396007274 |
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Provider Enumeration Date | 06/15/2012 |
Last Update Date | 06/15/2012 |
Medicare PECOS PAC ID | 2860658499 |
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Medicare Enrollment ID | O20120725000579 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396007274 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | M3739 (Texas) | Primary |
208000000X | Pediatrics | M3739 (Texas) | Secondary |
Provider Name | Premila Ls Johnson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1184727562 PECOS PAC ID: 4880792449 Enrollment ID: I20070605000250 |
Provider Name | Edward Maurice Lopez |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538479969 PECOS PAC ID: 5799935458 Enrollment ID: I20121016000261 |
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