Provider Demographics
NPI:1831579788
Name:JOE, BRENT ANDREW (AUD)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:ANDREW
Last Name:JOE
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:109 CENTRAL EXPY N
Mailing Address - Street 2:533
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2645
Mailing Address - Country:US
Mailing Address - Phone:972-359-7800
Mailing Address - Fax:972-359-7963
Practice Address - Street 1:109 CENTRAL EXPY N
Practice Address - Street 2:533
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2645
Practice Address - Country:US
Practice Address - Phone:972-359-7800
Practice Address - Fax:972-359-7963
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80768231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist