Provider Demographics
NPI:1023222072
Name:JOSHI, DAVEN (OD)
Entity Type:Individual
Prefix:
First Name:DAVEN
Middle Name:
Last Name:JOSHI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 MANDERS CT
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-5351
Mailing Address - Country:US
Mailing Address - Phone:214-636-2297
Mailing Address - Fax:
Practice Address - Street 1:1701 W STATE HIGHWAY 114
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-8652
Practice Address - Country:US
Practice Address - Phone:817-251-1091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6351152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management