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General NPI Number Information
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NPI Number | 1386597078
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Entity Type | Individual
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Provider Name | TONY JOHNSON
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Gender | Male
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Dates
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Enumeration Date | 02/20/2026
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 4008 E STAN SCHLUETER LOOP STE 108-109
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City | KILLEEN
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State | TX
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Zip | 76542-8536
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Country | US
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Telephone | 254-245-8003
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Fax | 254-245-8022
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Provider Business Mailing Address
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Address Line | 286 FAY DR
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City | KILLEEN
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State | TX
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Zip | 76542-7594
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT138773
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License Number State | TX
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