Individual provider Active NPI

Myracle Johnson

  • Developmental - Behavioral Pediatrics Physician
  • Killeen, TX
National Provider Identifier
1639088149
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
RBT-26-2845002 Issued in TX
Practice address
3106 S W S Young Dr Ste B-204
Killeen, TX 76542-2000
Phone
(254) 651-1994
NPI assigned
Sep 2, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X RBT-26-2845002 TX Primary

Addresses

Primary practice location

3106 S W S Young Dr Ste B-204
Killeen, TX 76542-2000

Mailing address

3106 S W S Young Dr Ste B-204
Killeen, TX 76542-2000
Phone (254) 651-1994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1639088149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3106 S W S YOUNG DR STE B-204",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765422000",
            "telephone_number": "254-651-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 S W S YOUNG DR STE B-204",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765422000",
            "telephone_number": "254-651-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MYRACLE",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-09-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "TX",
            "license": "RBT-26-2845002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.