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Individual

DR. MICHAEL DEAN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
14740 BARRYKNOLL LN, SUITE 130, HOUSTON, TX 77079
(281) 679-0333
(281) 679-6545
Mailing address
14740 BARRYKNOLL LN, SUITE 130, HOUSTON, TX 77079-2884
(281) 679-0333
(281) 679-6545

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
30562
TX
103TC0700X
Clinical Psychologist
Primary
30562
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004GD
BLUE CROSS
TX
05
149851101
TX
01
231238
VALUE OPTIONS
TX
Enumeration date
11/17/2006
Last updated
06/19/2018
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