Provider Demographics
NPI:1023397999
Name:SIMPSON, JOSHUA JOHN (PA)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JOHN
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3110 GUADALUPE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-2858
Mailing Address - Country:US
Mailing Address - Phone:540-373-4602
Mailing Address - Fax:512-599-9511
Practice Address - Street 1:3110 GUADALUPE ST STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2858
Practice Address - Country:US
Practice Address - Phone:512-599-9510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004469363A00000X
TXPA13462363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant