NPIMap

Organization Active NPI

Icon Wellness Center LLC

  • Family Medicine Physician
  • Webster, TX
National Provider Identifier
1376791426
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ICON WELLNESS CENTER LLC
Doing business as
Icon Wellness Center LLC
Practice address
250 Blossom St
Suite 100
Webster, TX 77598-4204
Phone
(281) 724-0190
NPI assigned
Sep 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John Robert Johnston, MDNPI 1477547651
Title
Medical Director
Phone
(281) 724-0190

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

250 Blossom St
Suite 100
Webster, TX 77598-4204

Mailing address

250 Blossom St
Suite 100
Webster, TX 77598-4204
Phone (281) 724-0190

Other names 1

  • ICON WELLNESS CENTER LLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1376791426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 BLOSSOM ST",
            "address_2": "SUITE 100",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984204",
            "telephone_number": "281-724-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 BLOSSOM ST",
            "address_2": "SUITE 100",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984204",
            "telephone_number": "281-724-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICON WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "281-724-0190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ICON WELLNESS CENTER LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Webster, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.