Demi Johnson
Speech-Language Pathologist, in San Antonio, TX. Individual provider (NPI-1).
NPI number1003597261
StatusActive
Last updated in NPPESJul 28, 2023
Details
- NPI
- 1003597261
- Entity type
- Individual (NPI-1)
- Name
- Demi Johnson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 28, 2023
- Certification date
- Jul 11, 2023
- Last updated
- Jul 28, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 120176 | TX | Yes |
Practice location
8961 Tesoro DrSan Antonio, TX 78217-6209
Phone 210-407-0000
Mailing address
6079 Crab OrchSan Antonio, TX 78240-2227
Phone 480-768-7769
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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