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General NPI Number Information
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NPI Number | 1215557152
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Entity Type | Organization
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Legal Business Name | PHOENIX MENTAL HEALTH TMS PLLC
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 23119 W INTERSTATE 10 BLDG 7
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1767
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Country | US
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Telephone | 210-994-6336
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Fax | 210-994-6441
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Provider Business Mailing Address
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Address Line | 23119 W INTERSTATE 10 BLDG 7
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1767
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Country | US
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Telephone | 210-994-6336
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Fax | 210-994-6441
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Authorized Official
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Title or Position | OWNER
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Name | DR. NATHAN JOHNSTON
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Credential | DO, MS
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Telephone | 210-994-6336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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