Provider Demographics
NPI:1992748818
Name:MYERS, JOSEPH WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:MYERS
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:4101 JAMES CASEY ST
Practice Address - Street 2:SUITE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3325
Practice Address - Country:US
Practice Address - Phone:512-447-2202
Practice Address - Fax:512-447-3802
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5666207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135740207Medicaid
TX45716001Medicaid
TX8R1510OtherBLUE CROSS OF TX
TX135740201Medicaid
TX135740209Medicaid
TX135740202Medicaid
E21754Medicare UPIN
TX87695KMedicare PIN
TX135740209Medicaid
TX8D5765Medicare PIN