Provider Demographics
NPI:1053026328
Name:ALLY PSYCHOLOGICAL HEALTH PLLC
Entity type:Organization
Organization Name:ALLY PSYCHOLOGICAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:972-275-6880
Mailing Address - Street 1:130 N PRESTON RD STE 107
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-3185
Mailing Address - Country:US
Mailing Address - Phone:972-275-6880
Mailing Address - Fax:844-205-9001
Practice Address - Street 1:130 N PRESTON RD STE 107
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-3185
Practice Address - Country:US
Practice Address - Phone:972-275-6880
Practice Address - Fax:844-205-9001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1891245254OtherTHOMAS JOHNSON