Organization Active NPI

Kevin J Johnson

Doing business as Cullen Medical Center

  • Prescribing (Medical) Psychologist
  • Houston, TX
National Provider Identifier
1700031762
Registry record updated Jul 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prescribing (Medical) PsychologistTaxonomy code 103TP0016X
License
H0554 Issued in TX
Legal business name
KEVIN J JOHNSON
Doing business as
Cullen Medical Center
Practice address
12805 Cullen Blvd.
D
Houston, TX 77047
Phone
(713) 738-6955
NPI assigned
Nov 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2009

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

Authorized official

Name
Mr. Kevin Jerome Johnson
Title
Owner
Phone
(713) 738-6955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP0016X H0554 TX Primary

Addresses

Primary practice location

12805 Cullen Blvd.
D
Houston, TX 77047

Mailing address

12805 Cullen Blvd.
D
Houston, TX 77047
Phone (713) 738-6955

Other names 1

  • Cullen Medical Center 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.

NPI Registry JSON

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

{
    "created_epoch": "1226966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247184000000",
    "number": "1700031762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12805 CULLEN BLVD.",
            "address_2": "D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77047",
            "telephone_number": "713-738-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12805 CULLEN BLVD.",
            "address_2": "D",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77047",
            "telephone_number": "713-738-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN J JOHNSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-18",
        "last_updated": "2009-07-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-738-6955",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "TX",
            "license": "H0554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cullen Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; 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.