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Individual

TIYA SHALYSE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
(903) 877-7168
(903) 877-8355
Mailing address
11937 US HIGHWAY 271, TYLER, TX 75708-3154
(903) 877-7168
(903) 877-8355

Taxonomy

Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
130324
OH
2084F0202X
Forensic Psychiatry Physician
48143
KY
2084F0202X
Forensic Psychiatry Physician
ME129560
FL
2084P0800X
Psychiatry Physician
130324
OH
2084P0800X
Psychiatry Physician
48143
KY
2084P0800X
Psychiatry Physician
ME129560
FL
2084P0804X
Child & Adolescent Psychiatry Physician
130324
OH
2084P0804X
Child & Adolescent Psychiatry Physician
48143
KY
2084P0804X
Child & Adolescent Psychiatry Physician
ME129560
FL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
S7462
TX

Other

Enumeration date
03/20/2012
Last updated
08/17/2020
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