Provider Demographics
NPI:1093584450
Name:NUYTTENS, JOSHUA
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:NUYTTENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 COUNTY ROAD 665
Mailing Address - Street 2:
Mailing Address - City:DEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:78016-4746
Mailing Address - Country:US
Mailing Address - Phone:210-835-5649
Mailing Address - Fax:
Practice Address - Street 1:300 W OLMOS DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-1958
Practice Address - Country:US
Practice Address - Phone:210-829-1705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician