Provider Demographics
NPI:1053628016
Name:NEVELS, JOSHUA WALDON-ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:WALDON-ROBERT
Last Name:NEVELS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24124 CINCO VILLAGE CENTER BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-8396
Mailing Address - Country:US
Mailing Address - Phone:281-574-5539
Mailing Address - Fax:281-574-6223
Practice Address - Street 1:24124 CINCO VILLAGE CENTER BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-8396
Practice Address - Country:US
Practice Address - Phone:770-296-9189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11484111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor