Provider Demographics
NPI:1407848567
Name:JUREN, JOE H (MD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:H
Last Name:JUREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1030
Mailing Address - Country:US
Mailing Address - Phone:512-458-6656
Mailing Address - Fax:512-458-1035
Practice Address - Street 1:3705 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1019
Practice Address - Country:US
Practice Address - Phone:512-458-6656
Practice Address - Fax:512-458-1035
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:2006-04-03
Deactivation Code:
Reactivation Date:2006-05-01
Provider Licenses
StateLicense IDTaxonomies
TXF8530174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00NL90OtherBLUE CROSS/BLUE SHIELD
TX00NL90OtherBLUE CROSS/BLUE SHIELD
TXB23799Medicare UPIN