| Premila Johnson, Md Lp | |
|
2300 W Michigan Ave Suite 5 Midland TX 79701-5808 | |
| (432) 413-5496 | |
| Not Available |
| Full Name | Premila Johnson, Md Lp |
|---|---|
| Speciality | Internal Medicine |
| Location | 2300 W Michigan Ave, Midland, Texas |
| Authorized Official Name and Position | Premila Lakshmi Singh Johnson (PHYSICIAN/OWNER) |
| Authorized Official Contact | 4324135496 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premila Johnson, Md Lp 2300 W Michigan Ave Suite 5 Midland TX 79701-5808 Ph: () - | Premila Johnson, Md Lp 2300 W Michigan Ave Suite 5 Midland TX 79701-5808 Ph: (432) 413-5496 |
| NPI Number | 1396007274 |
|---|---|
| Provider Enumeration Date | 06/15/2012 |
| Last Update Date | 06/15/2012 |
| Medicare PECOS PAC ID | 2860658499 |
|---|---|
| Medicare Enrollment ID | O20120725000579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396007274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | M3739 (Texas) | Primary |
| 208000000X | Pediatrics | M3739 (Texas) | Secondary |
| Provider Name | Premila Ls Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184727562 PECOS PAC ID: 4880792449 Enrollment ID: I20070605000250 |
| Provider Name | Edward Maurice Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538479969 PECOS PAC ID: 5799935458 Enrollment ID: I20121016000261 |
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