Provider Demographics
NPI:1265408033
Name:PRICKETT, JOSH (MD)
Entity type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:PRICKETT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8950 N TARRANT PKWY
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-8465
Mailing Address - Country:US
Mailing Address - Phone:817-281-7277
Mailing Address - Fax:817-514-4295
Practice Address - Street 1:8950 N TARRANT PKWY
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-8465
Practice Address - Country:US
Practice Address - Phone:817-281-7277
Practice Address - Fax:817-514-4295
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7373207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX047381101Medicaid
TX86345GOtherBCBS THRU HEB
TX930077830OtherRAILROAD MCARE THRU HEB
TXF05228Medicare UPIN
TX047381101Medicaid