Provider Demographics
NPI:1821976325
Name:PHILIP, JOSHUA JACOB (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:JACOB
Last Name:PHILIP
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:JOSH
Other - Middle Name:JACOB
Other - Last Name:PHILIP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1701 ROGERS RD APT 405
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-6596
Mailing Address - Country:US
Mailing Address - Phone:281-687-5366
Mailing Address - Fax:
Practice Address - Street 1:4700 BRYANT IRVIN CT STE 303
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-7645
Practice Address - Country:US
Practice Address - Phone:281-687-5366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40359103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist