Healthcare Provider Details

I. General information

NPI: 1669432712
Provider Name (Legal Business Name): JOSEPH JOHN LAUHON PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VALERO EMPLOYEE CENTER 6701 FM119, HCR BOX 36, SUITE 170
SUNRAY TX
79086
US

IV. Provider business mailing address

7710 TIMBER SWITCH RD
CLEVELAND TX
77328-8351
US

V. Phone/Fax

Practice location:
  • Phone: 806-935-1503
  • Fax: 806-935-1429
Mailing address:
  • Phone: 936-444-7746
  • Fax: 806-935-1429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number05546
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: