Provider Demographics
NPI:1124557764
Name:JOHNSTON, DALLAS (DC)
Entity type:Individual
Prefix:DR
First Name:DALLAS
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16051 DESSAU RD
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-5825
Mailing Address - Country:US
Mailing Address - Phone:512-646-4160
Mailing Address - Fax:512-646-4162
Practice Address - Street 1:16051 DESSAU RD
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-5825
Practice Address - Country:US
Practice Address - Phone:512-646-4160
Practice Address - Fax:512-646-4162
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13405111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor