Provider Demographics
NPI:1467617571
Name:KARTYE, JOSEPH P JR (PHD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:KARTYE
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7245 FM 1275
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-3867
Mailing Address - Country:US
Mailing Address - Phone:936-569-0293
Mailing Address - Fax:936-569-7207
Practice Address - Street 1:7245 FM 1275
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-3867
Practice Address - Country:US
Practice Address - Phone:936-569-0293
Practice Address - Fax:936-569-7207
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20894103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030992401Medicaid