Provider Demographics
NPI:1033522461
Name:JOHNSON, TRENICE (NP)
Entity Type:Individual
Prefix:
First Name:TRENICE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11111 KATY FWY STE 910
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2119
Mailing Address - Country:US
Mailing Address - Phone:713-464-1343
Mailing Address - Fax:713-464-1372
Practice Address - Street 1:2000 CRAWFORD ST STE 865
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-2244
Practice Address - Country:US
Practice Address - Phone:713-464-1343
Practice Address - Fax:844-822-7794
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07768363LF0000X, 363LP0808X
TXAP125607363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health