Provider Demographics
NPI:1144270786
Name:JOHNSON, MARIA SUZANNE (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:SUZANNE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 SOUTHWEST FWY STE 2100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7525
Mailing Address - Country:US
Mailing Address - Phone:833-208-7770
Mailing Address - Fax:
Practice Address - Street 1:3200 SOUTHWEST FWY STE 2100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7525
Practice Address - Country:US
Practice Address - Phone:833-208-7770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0774207PP0204X, 208000000X
MT143464208000000X
NC2024-00313208000000X
DCMD600001957208000000X
FLME165939208000000X
IL036.173856208000000X
LA343129208000000X
MI4301510719208000000X
MO2025018784208000000X
MS33854208000000X
NJ25IA12555300208000000X
NY334294208000000X
TN72136208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209128602Medicaid
2697919Medicare ID - Type Unspecified
I14345Medicare UPIN