Provider Demographics
NPI:1295925287
Name:JOHNSTONE, EDWIN ENOCH (MD)
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:ENOCH
Last Name:JOHNSTONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 SOUTH SHEPHERD DRIVE
Mailing Address - Street 2:SUITE 908
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-7024
Mailing Address - Country:US
Mailing Address - Phone:713-528-4000
Mailing Address - Fax:713-528-4004
Practice Address - Street 1:2323 SOUTH SHEPHERD DRIVE
Practice Address - Street 2:SUITE 908
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-7024
Practice Address - Country:US
Practice Address - Phone:713-528-4000
Practice Address - Fax:713-528-4004
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD16882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry