Provider Demographics
NPI:1821711698
Name:REEVES, SARITA JOHNSON (LICENSED VOCATIONAL)
Entity Type:Individual
Prefix:MRS
First Name:SARITA
Middle Name:JOHNSON
Last Name:REEVES
Suffix:
Gender:F
Credentials:LICENSED VOCATIONAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 RUSK ST # 1300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-2713
Mailing Address - Country:US
Mailing Address - Phone:832-323-9271
Mailing Address - Fax:832-553-5299
Practice Address - Street 1:720 RUSK ST # 1300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-2713
Practice Address - Country:US
Practice Address - Phone:832-323-9271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313387164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX313387OtherTEXAS BOARD OF NURSING
TX313387OtherLVN LICENSE