Provider Demographics
NPI:1770626228
Name:AUZENNE, JOSHUA BARRETT (DC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:BARRETT
Last Name:AUZENNE
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 1:7460 GOLDEN POND
Mailing Address - Street 2:SUITE 400
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79121
Mailing Address - Country:US
Mailing Address - Phone:806-356-7104
Mailing Address - Fax:806-356-7141
Practice Address - Street 1:7460 GOLDEN POND
Practice Address - Street 2:SUITE 400
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79121
Practice Address - Country:US
Practice Address - Phone:806-356-7104
Practice Address - Fax:806-356-7141
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10337111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10337OtherSTATE LICENSE