Provider Demographics
NPI:1871878298
Name:JOHNSON, TYLER CHASE (DC)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:CHASE
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9325 TARVER DR
Mailing Address - Street 2:STE C-102
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-6162
Mailing Address - Country:US
Mailing Address - Phone:806-224-0063
Mailing Address - Fax:806-771-5388
Practice Address - Street 1:9325 TARVER DR
Practice Address - Street 2:STE C-102
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-6162
Practice Address - Country:US
Practice Address - Phone:806-224-0063
Practice Address - Fax:806-771-5388
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11906111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor