Individual
DR. JOHNNY KENNETH BURKHALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3115 LOOP 306, SUITE 101, SAN ANGELO, TX 76904
(325) 944-4722
(325) 223-1150
Mailing address
3115 LOOP 306, SUITE 101, SAN ANGELO, TX 76904
(325) 944-4722
(325) 223-1150
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
22463
TX
103TS0200X
School Psychologist
Primary
6094
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00GK54
BCBS
TX
Enumeration date
10/05/2006
Last updated
09/11/2025
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