Provider Demographics
NPI:1528393451
Name:JOSH WARREN MD PA
Entity Type:Organization
Organization Name:JOSH WARREN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:254-772-8055
Mailing Address - Street 1:6001 W WACO DR STE M
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-6309
Mailing Address - Country:US
Mailing Address - Phone:254-772-8055
Mailing Address - Fax:254-772-3019
Practice Address - Street 1:6001 W WACO DR STE M
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-6309
Practice Address - Country:US
Practice Address - Phone:254-772-8055
Practice Address - Fax:254-772-3019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM46402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX613742Medicare PIN