Individual provider Active NPI

Alan Edward Johnson, PSYD

  • Psychologist
  • Dallas, TX
National Provider Identifier
1417329905
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
37103 Issued in TX
Practice address
4100 Spring Valley Rd Ste 910
Dallas, TX 75244-3646
Phone
(214) 945-2727
Fax
(972) 449-7075
NPI assigned
Oct 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 37103 TX Primary

Addresses

Primary practice location

4100 Spring Valley Rd Ste 910
Dallas, TX 75244-3646

Mailing address

5900 Balcones Dr Ste 100
Austin, TX 78731-4298
Phone (214) 945-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160707000245 TX Practitioner - Clinical Psychologist 9032401336 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37103TXMDPsychologist
37013TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Eudaimonia Wellness, PLLC CurrentSince Apr 6, 2023 Accepting new patients
Center for Psychological Services, PLLC Psychologist Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Psychologist CurrentSince Apr 1, 2019 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Apr 1, 2019 Accepting new patients
Center for Psychological Services, PLLC CurrentSince Jun 1, 2016 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

6043 W Interstate 20
Arlington, TX 76017
Phone (817) 533-0825

5900 Balcones Dr
Ste 100
Austin, TX 78731

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

3333 Lee Pkwy
Ste 600
Dallas, TX 75219
Phone (817) 533-0825

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

4100 Spring Valley Rd
Ste 910
Farmers Branch, TX 75244
Phone (214) 945-2727

1307 8th Ave
Ste 310
Ft Worth, TX 76104
Phone (817) 533-0825

1208 Fall Creek Hwy
Ste E
Granbury, TX 76049
Phone (817) 533-0818

2001 Inwood Rd
Ut Southwest Medical Center, TX 75390
Phone (214) 645-8000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1417329905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BALCONES DR STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314298",
            "telephone_number": "214-945-2727",
            "fax_number": "972-449-7075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 SPRING VALLEY RD STE 910",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443646",
            "telephone_number": "214-945-2727",
            "fax_number": "972-449-7075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-23",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "37103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.