Healthcare Provider Details

I. General information

NPI: 1114834603
Provider Name (Legal Business Name): BRYCE JOHNSON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 HWY N 287
MANSFIELD TX
76063
US

IV. Provider business mailing address

5306 HIDDEN TRAILS DR
ARLINGTON TX
76017-2170
US

V. Phone/Fax

Practice location:
  • Phone: 817-453-6770
  • Fax:
Mailing address:
  • Phone: 817-773-3548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number77612
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: