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General NPI Number Information
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NPI Number | 1164217675
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Entity Type | Individual
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Provider Name | JOSHUA THOMAS-NUNN
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Gender | Male
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 611 S CONGRESS AVE STE 205
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City | AUSTIN
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State | TX
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Zip | 78704-1729
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Country | US
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Telephone | 512-786-2014
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Fax |
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Provider Business Mailing Address
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Address Line | 7631 HIGHWAY 290 W APT 216
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City | AUSTIN
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State | TX
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Zip | 78736-3605
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Country | US
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Telephone | 512-786-2014
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT048682
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License Number State | TX
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