Provider Demographics
NPI:1558399378
Name:SIMPSON, JOSEPH ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ANTHONY
Last Name:SIMPSON
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 1:9480 HUEBNER RD
Mailing Address - Street 2:STE 210
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1655
Mailing Address - Country:US
Mailing Address - Phone:210-614-9595
Mailing Address - Fax:210-615-7362
Practice Address - Street 1:9480 HUEBNER RD
Practice Address - Street 2:STE 210
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1655
Practice Address - Country:US
Practice Address - Phone:210-614-9595
Practice Address - Fax:210-615-7362
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5938174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX118477204Medicaid
TX00542FMedicare ID - Type Unspecified
TX118477204Medicaid