Provider Demographics
NPI:1043989437
Name:JOHNSON, CHRISTOPHER ANDRE (CPHT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ANDRE
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CHRIS JOHNSON
Mailing Address - Street 1:19777 DEERBROOK PARK BLVD APT 214
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-2864
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5251 FM 2920 RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-3004
Practice Address - Country:US
Practice Address - Phone:281-323-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX229693183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician