Provider Demographics
NPI:1154371979
Name:JOHNSON, CHARLES ANDERS (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:ANDERS
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 BEECHNUT ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-3106
Mailing Address - Country:US
Mailing Address - Phone:713-777-7145
Mailing Address - Fax:713-337-4803
Practice Address - Street 1:146 E HOSPITAL DR STE 210
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-4171
Practice Address - Country:US
Practice Address - Phone:979-849-8516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3900207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138794610Medicaid
TXE76999Medicare UPIN
TX86X125Medicare PIN