Provider Demographics
NPI:1487955605
Name:SCOTT JOHNSON, BRIDGETTE RENEE (RPH)
Entity type:Individual
Prefix:MRS
First Name:BRIDGETTE
Middle Name:RENEE
Last Name:SCOTT JOHNSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 SAWDUST RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2272
Mailing Address - Country:US
Mailing Address - Phone:281-292-0774
Mailing Address - Fax:281-292-6415
Practice Address - Street 1:130 SAWDUST RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2272
Practice Address - Country:US
Practice Address - Phone:281-292-0774
Practice Address - Fax:281-292-6415
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31285183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist