Provider Demographics
NPI:1992232888
Name:JOSHI, SUBHASH ANIRUDDHA (MD)
Entity type:Individual
Prefix:
First Name:SUBHASH
Middle Name:ANIRUDDHA
Last Name:JOSHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5017 ALICIA DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-7903
Mailing Address - Country:US
Mailing Address - Phone:817-294-4580
Mailing Address - Fax:
Practice Address - Street 1:1100 FM 1807
Practice Address - Street 2:
Practice Address - City:VENUS
Practice Address - State:TX
Practice Address - Zip Code:76084-3966
Practice Address - Country:US
Practice Address - Phone:972-366-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG41372080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology