Provider Demographics
NPI:1447245683
Name:FINE, JOSHUA K (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:K
Last Name:FINE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3600 GASTON AVE
Mailing Address - Street 2:SUITE 1205
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:214-826-6235
Mailing Address - Fax:214-828-4633
Practice Address - Street 1:3417 GASTON AVE
Practice Address - Street 2:SUITE 830
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-0830
Practice Address - Country:US
Practice Address - Phone:214-826-6235
Practice Address - Fax:214-828-4633
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2017-02-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH6218208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX114605204Medicaid
TXP00300421OtherRR MEDICARE
TXP00300421OtherRR MEDICARE
TX8G5648Medicare PIN