Healthcare Provider Details

I. General information

NPI: 1932319803
Provider Name (Legal Business Name): JOSHUA HUNTER GREENE OPA-C, LSA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 10/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4803 ARROWHEAD LAKE DR
MISSOURI CITY TX
77459-6545
US

IV. Provider business mailing address

4803 ARROWHEAD LAKE DR
MISSOURI CITY TX
77459-6545
US

V. Phone/Fax

Practice location:
  • Phone: 903-826-3302
  • Fax:
Mailing address:
  • Phone: 903-826-3302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT001313
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: