Provider Demographics
NPI:1346839594
Name:WILLIAMS, JOSHUA DAMONE
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:DAMONE
Last Name:WILLIAMS
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 1:3630 PACIFIC WAY
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-4781
Mailing Address - Country:US
Mailing Address - Phone:214-616-7386
Mailing Address - Fax:
Practice Address - Street 1:3630 PACIFIC WAY
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-4781
Practice Address - Country:US
Practice Address - Phone:214-616-7386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT130500225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist