Provider Demographics
NPI:1619232113
Name:JOHNSTON, NATHAN S
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:S
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23119 W INTERSTATE 10 BLDG 7
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1767
Mailing Address - Country:US
Mailing Address - Phone:210-994-6336
Mailing Address - Fax:210-994-6441
Practice Address - Street 1:23119 W INTERSTATE 10 BLDG 7
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1767
Practice Address - Country:US
Practice Address - Phone:210-994-6336
Practice Address - Fax:210-994-6441
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ67552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry