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NPI Code Detail

MEDICARE: MRS. KRISTAL G JOHNSON SLP

MEDICARE: MRS. KRISTAL G JOHNSON SLP
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
1235Z00000XSpeech-Language Pathologist19360TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18T2903OTHERTXBCBS ID

General Provider Information

NPI Number : 1952475188
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTAL G JOHNSON SLP
Provider Business Mailing Address
First Line : 5800 BELL ST
Second Line :
City : AMARILLO
State : TX
Zip : 79109-6230
Country : US
Telephone Number : 806-677-5226
Fax Number : 806-677-5225
Provider Business Practice Location Address
First Line : 5800 BELL ST
Second Line :
City : AMARILLO
State : TX
Zip : 79109-6230
Country : US
Telephone Number : 806-677-5226
Fax Number : 806-677-5225
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2006
Last Update Date : 07/09/2007

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Directions to “ MRS. KRISTAL G JOHNSON SLP” Practice Location

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