Provider Demographics
NPI:1548211295
Name:JOHNSON, THOMAS CHESTER (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CHESTER
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 W 8TH AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79101-2399
Mailing Address - Country:US
Mailing Address - Phone:806-353-1668
Mailing Address - Fax:806-353-1668
Practice Address - Street 1:112 W 8TH AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79101-2399
Practice Address - Country:US
Practice Address - Phone:806-353-1668
Practice Address - Fax:806-353-1668
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25058103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist