Provider Demographics
NPI:1588436711
Name:JON JOSHUA
Entity type:Organization
Organization Name:JON JOSHUA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EHIJELE
Authorized Official - Middle Name:ERONS
Authorized Official - Last Name:UNUIGBE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:713-204-0604
Mailing Address - Street 1:11834 GREEN COLLING PARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-2550
Mailing Address - Country:US
Mailing Address - Phone:713-204-0604
Mailing Address - Fax:
Practice Address - Street 1:11834 GREEN COLLING PARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-2550
Practice Address - Country:US
Practice Address - Phone:713-204-0604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty