Provider Demographics
NPI:1487300067
Name:JOHNSTON, PHILIP (RPH)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 CANYON CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3299
Mailing Address - Country:US
Mailing Address - Phone:254-410-5136
Mailing Address - Fax:
Practice Address - Street 1:1201 CANYON CREEK DR
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3299
Practice Address - Country:US
Practice Address - Phone:254-410-5136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX333611835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric