Provider Demographics
NPI:1356510911
Name:DUARTE, JOE ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:ANTHONY
Last Name:DUARTE
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 1:6011 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-4554
Mailing Address - Country:US
Mailing Address - Phone:210-771-2136
Mailing Address - Fax:210-247-9463
Practice Address - Street 1:6011 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-4554
Practice Address - Country:US
Practice Address - Phone:210-771-2136
Practice Address - Fax:210-247-9463
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10778111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10778OtherSTATE LICENSE