Provider Demographics
NPI:1902501919
Name:JOSEPH, PAUL STEPHEN
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:STEPHEN
Last Name:JOSEPH
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 1:3514 MARIS WAY
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4429
Mailing Address - Country:US
Mailing Address - Phone:832-342-8468
Mailing Address - Fax:
Practice Address - Street 1:3514 MARIS WAY
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4429
Practice Address - Country:US
Practice Address - Phone:832-342-8468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15661426172A00000X
347E00000X
TX343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No172A00000XOther Service ProvidersDriverGroup - Single Specialty
No347E00000XTransportation ServicesTransportation Broker