Provider Demographics
NPI:1235863051
Name:WALKER, JOHNNY JR
Entity Type:Individual
Prefix:
First Name:JOHNNY
Middle Name:
Last Name:WALKER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9449 BRIAR FOREST DR APT 1401
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1042
Mailing Address - Country:US
Mailing Address - Phone:281-865-6888
Mailing Address - Fax:
Practice Address - Street 1:9449 BRIAR FOREST DR APT 1401
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1042
Practice Address - Country:US
Practice Address - Phone:281-865-6888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-16
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral