Provider Demographics
NPI:1205153640
Name:MORGAN-JOHNSON, JACQUELINE RENITA (RPSGT)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:RENITA
Last Name:MORGAN-JOHNSON
Suffix:
Gender:F
Credentials:RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 S MASON RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2449
Mailing Address - Country:US
Mailing Address - Phone:281-665-3980
Mailing Address - Fax:281-665-3987
Practice Address - Street 1:462 S MASON RD
Practice Address - Street 2:SUITE 400
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2449
Practice Address - Country:US
Practice Address - Phone:281-665-3980
Practice Address - Fax:281-665-3987
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73992472E0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG