Provider Demographics
NPI:1205136744
Name:JOHNSON, SARAH ELIZABETH (AUD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 N MIDKIFF RD
Mailing Address - Street 2:SUITE 168
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-4828
Mailing Address - Country:US
Mailing Address - Phone:432-260-7637
Mailing Address - Fax:
Practice Address - Street 1:3303 N MIDKIFF RD
Practice Address - Street 2:SUITE 168
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-4828
Practice Address - Country:US
Practice Address - Phone:432-260-7637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80247231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2864373Medicaid
TXTXB136498OtherMEDICARE