Provider Demographics
NPI:1932607389
Name:GEORGE, JOHANNES MARK
Entity Type:Individual
Prefix:DR
First Name:JOHANNES
Middle Name:MARK
Last Name:GEORGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14819 BELTERRAZA DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-6762
Mailing Address - Country:US
Mailing Address - Phone:832-594-8913
Mailing Address - Fax:281-617-7564
Practice Address - Street 1:14819 BELTERRAZA DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-6762
Practice Address - Country:US
Practice Address - Phone:832-594-8913
Practice Address - Fax:281-617-7564
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82-4004828OtherPERSONAL ASSISTANT SERVICES