MEDICARE: TAMYRA JOHNSON PSYD PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1972452589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMYRA JOHNSON PSYD PLLC

Provider Business Mailing Address
First Line	:	9608 NATHAN WAY
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75025-5896
Country	:	US
Telephone Number	:	469-209-5983
Fax Number	:

Provider Business Practice Location Address
First Line	:	1340 PRUDENTIAL DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-4115
Country	:	US
Telephone Number	:	469-209-5983
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	TAMYRA JOHNSON
Credential	:	PSYD
Telephone Number	:	469-209-5983

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	05/04/2026

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