Healthcare Provider Details

I. General information

NPI: 1710891718
Provider Name (Legal Business Name): JOSHUA JAMES HEATER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14018 NESKAR DR
PFLUGERVILLE TX
78660-1776
US

IV. Provider business mailing address

14018 NESKAR DR
PFLUGERVILLE TX
78660-1776
US

V. Phone/Fax

Practice location:
  • Phone: 702-469-2774
  • Fax:
Mailing address:
  • Phone: 702-469-2774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number120531
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: