Provider Demographics
NPI:1568838027
Name:JOHNSON, ALLISON (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 SILVERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4208
Mailing Address - Country:US
Mailing Address - Phone:214-914-2484
Mailing Address - Fax:
Practice Address - Street 1:17045 EL CAMINO REAL
Practice Address - Street 2:UNIT 106
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2649
Practice Address - Country:US
Practice Address - Phone:214-914-2484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1262916225100000X
2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics