Provider Demographics
NPI:1568073690
Name:THARIAN, JOSHUA
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:THARIAN
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 1:13938 PEYTON DR
Mailing Address - Street 2:APT 114
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-3655
Mailing Address - Country:US
Mailing Address - Phone:214-355-8064
Mailing Address - Fax:
Practice Address - Street 1:13938 PEYTON DR
Practice Address - Street 2:APT 114
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-3655
Practice Address - Country:US
Practice Address - Phone:214-355-8064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist