Basic Information
| Provider Information | |||||||||
| NPI: | 1467497735 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JOSEPH DANIELS, DO | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | SOUTHWEST ORTHOPEDIC ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | 6311 SOUTHWEST BLVD | ||||||||
| Address2: | |||||||||
| City: | BENBROOK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761321063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177319400 | ||||||||
| FaxNumber: | 8177314282 | ||||||||
| Practice Location | |||||||||
| Address1: | 6311 SOUTHWEST BLVD | ||||||||
| Address2: | |||||||||
| City: | BENBROOK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761321063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177319400 | ||||||||
| FaxNumber: | 8177314282 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2006 | ||||||||
| LastUpdateDate: | 10/22/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | MONAGHAN | ||||||||
| AuthorizedOfficialFirstName: | PAM | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | RN | ||||||||
| AuthorizedOfficialTelephone: | 8177319400 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 10/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 2081P2900X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine | 207X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 8V9721 | 01 | BCBSTX | OTHER | 8J6577 | 01 | MCGRATH IND MEDICARE # | OTHER | 8V9720 | 01 | BCBSTX | OTHER | 8G9143 | 01 | DANIELS MEDICARE # | OTHER |