Provider Demographics
NPI:1386664266
Name:TREADAWAY, JOE P (MD)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:P
Last Name:TREADAWAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 2239
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-795-4441
Mailing Address - Fax:713-795-5034
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 961
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-795-4441
Practice Address - Fax:713-795-5034
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2008-09-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXD96902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122051903Medicaid
TX122051903Medicaid