Provider Demographics
NPI:1659307379
Name:YONKER, JOSHUA CHARLES (MS, LAT, ATC)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:CHARLES
Last Name:YONKER
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 RED BIRD LANE
Mailing Address - Street 2:CAMPUS BOX 10611
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77710
Mailing Address - Country:US
Mailing Address - Phone:409-880-2359
Mailing Address - Fax:409-880-2366
Practice Address - Street 1:4400 S. MLK JR PKWY
Practice Address - Street 2:LAMAR UNIV. DAUPHIN ATHLETIC COMPLEX
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77705
Practice Address - Country:US
Practice Address - Phone:409-880-2359
Practice Address - Fax:409-880-2366
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2022-07-21
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2017-06-07
Provider Licenses
StateLicense IDTaxonomies
TXAT34572255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer