Provider Demographics
NPI:1962474494
Name:JOHNSON, LINDY M (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDY
Middle Name:M
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12344 BARKER CYPRESS RD STE 130
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-0014
Mailing Address - Country:US
Mailing Address - Phone:281-894-5020
Mailing Address - Fax:281-894-5019
Practice Address - Street 1:12344 BARKER CYPRESS ROAD SUITE 130
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429
Practice Address - Country:US
Practice Address - Phone:281-894-5020
Practice Address - Fax:281-894-5019
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9565111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BM063OtherBCBS
TX608114OtherBCBS
TX4442839OtherCIGNA
TX611676Medicare ID - Type Unspecified