Provider Demographics
NPI:1689898819
Name:DURHAM, JOSHUA LEE (MD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:LEE
Last Name:DURHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8711 VILLAGE DR STE 114
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5419
Mailing Address - Country:US
Mailing Address - Phone:210-483-0888
Mailing Address - Fax:210-494-1740
Practice Address - Street 1:502 MADISON OAK DR STE 310
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4298
Practice Address - Country:US
Practice Address - Phone:210-483-0888
Practice Address - Fax:210-494-1740
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR1947207RC0000X
VA0101243397207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine