Provider Demographics
NPI:1942434469
Name:NOACK, JOSEPH
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:NOACK
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 1:16835 DEER CREEK DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-4968
Mailing Address - Country:US
Mailing Address - Phone:281-379-4373
Mailing Address - Fax:281-655-0762
Practice Address - Street 1:16835 DEER CREEK DR
Practice Address - Street 2:SUITE 120
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-4968
Practice Address - Country:US
Practice Address - Phone:281-379-4373
Practice Address - Fax:281-655-0762
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106619225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX17600601Medicaid