Provider Demographics
NPI:1508621764
Name:SARGENT, YOSHUA ISAAC
Entity Type:Individual
Prefix:
First Name:YOSHUA
Middle Name:ISAAC
Last Name:SARGENT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 WILLIAMS TRACE BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4514
Mailing Address - Country:US
Mailing Address - Phone:281-305-0034
Mailing Address - Fax:
Practice Address - Street 1:2205 WILLIAMS TRACE BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4514
Practice Address - Country:US
Practice Address - Phone:281-305-0034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician