Healthcare Provider Details

I. General information

NPI: 1336305820
Provider Name (Legal Business Name): JOYA K SYKES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2008
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E BROAD ST STE 308
MANSFIELD TX
76063-6412
US

IV. Provider business mailing address

2800 E BROAD ST STE 308
MANSFIELD TX
76063-6412
US

V. Phone/Fax

Practice location:
  • Phone: 682-242-4325
  • Fax: 682-622-4322
Mailing address:
  • Phone: 937-241-3720
  • Fax: 972-579-3900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number010241
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR1658
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: