Provider Demographics
NPI:1043233687
Name:WASSEF, JOSEPH SOLIMAN (MD, PC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:SOLIMAN
Last Name:WASSEF
Suffix:
Gender:M
Credentials:MD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 SYBIL LN STE 150
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-1830
Mailing Address - Country:US
Mailing Address - Phone:903-504-5459
Mailing Address - Fax:903-504-5460
Practice Address - Street 1:2010 SYBIL LN STE 150
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-1830
Practice Address - Country:US
Practice Address - Phone:903-504-5459
Practice Address - Fax:903-504-5460
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ24682084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136879710Medicaid
TX5295014OtherAETNA NUMBER
TX061730OtherVALUE OPTIONS NUMBER
TX00T73HOtherBLUE CROSS BLUE SHIELD
TX061730OtherVALUE OPTIONS NUMBER