Provider Demographics
NPI:1538848635
Name:JOHNSON, SULTANA MUSLIMA
Entity type:Individual
Prefix:
First Name:SULTANA
Middle Name:MUSLIMA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 SPRING GREEN BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7463
Mailing Address - Country:US
Mailing Address - Phone:832-883-8880
Mailing Address - Fax:832-218-3898
Practice Address - Street 1:23233 WESTERN CENTRE DR APT 2168
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6614
Practice Address - Country:US
Practice Address - Phone:832-883-8880
Practice Address - Fax:832-218-3898
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health