Provider Demographics
NPI:1386726628
Name:STEELE, JOSEPH (CRNA)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:STEELE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 HIGHWAY 83 NORTH,
Mailing Address - Street 2:
Mailing Address - City:CHILDRESS
Mailing Address - State:TN
Mailing Address - Zip Code:79201
Mailing Address - Country:US
Mailing Address - Phone:940-937-6371
Mailing Address - Fax:
Practice Address - Street 1:901 HIGHWAY 83 NORTH,
Practice Address - Street 2:
Practice Address - City:CHILDRESS
Practice Address - State:TX
Practice Address - Zip Code:79201
Practice Address - Country:US
Practice Address - Phone:940-937-6371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86772C207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126052304Medicaid
TX133250401Medicaid
TX751228349Medicare UPIN
TX126052304Medicaid