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General NPI Number Information
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NPI Number | 1417329905
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Entity Type | Individual
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Provider Name | ALAN EDWARD JOHNSON PSYD
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Gender | Male
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Dates
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Enumeration Date | 10/23/2015
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 4100 SPRING VALLEY RD STE 910
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City | DALLAS
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State | TX
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Zip | 75244-3646
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Country | US
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Telephone | 214-945-2727
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Fax | 972-449-7075
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Provider Business Mailing Address
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Address Line | 5900 BALCONES DR STE 100
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City | AUSTIN
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State | TX
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Zip | 78731-4298
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Country | US
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Telephone | 214-945-2727
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Fax | 972-449-7075
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 37103
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License Number State | TX
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