Provider Demographics
NPI:1588820054
Name:SULTZ, JOSHUA DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DAVID
Last Name:SULTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2206 E VILLA MARIA RD
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2547
Mailing Address - Country:US
Mailing Address - Phone:979-776-4600
Mailing Address - Fax:979-776-8749
Practice Address - Street 1:2206 E VILLA MARIA RD
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2547
Practice Address - Country:US
Practice Address - Phone:979-776-4600
Practice Address - Fax:979-776-8749
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9746207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine