Provider Demographics
NPI:1043592587
Name:TENBENSEL, JOSHUA JAMES (DPT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JAMES
Last Name:TENBENSEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N LEE AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-4423
Mailing Address - Country:US
Mailing Address - Phone:402-890-0253
Mailing Address - Fax:432-335-5365
Practice Address - Street 1:3003 N A ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-5304
Practice Address - Country:US
Practice Address - Phone:432-684-7755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-11
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3024225100000X
TX1330204225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1330204OtherTEXAS PT LICENSURE