Provider Demographics
NPI:1669895587
Name:WATKINS, JOSEPH ASHLEY
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ASHLEY
Last Name:WATKINS
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 1:2355 N HWY 360 APT 521
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-8715
Mailing Address - Country:US
Mailing Address - Phone:702-528-8968
Mailing Address - Fax:
Practice Address - Street 1:2355 N HWY 360 APT 521
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-8715
Practice Address - Country:US
Practice Address - Phone:702-528-8968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management