Provider Demographics
NPI:1710608708
Name:MICHAEL, JOSHUA S (DC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:S
Last Name:MICHAEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 HIDEAWAY CV
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-1883
Mailing Address - Country:US
Mailing Address - Phone:832-549-7152
Mailing Address - Fax:
Practice Address - Street 1:10310 W GRAND PKWY S STE 102B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-5923
Practice Address - Country:US
Practice Address - Phone:823-549-7152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2023-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15292111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor