=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548152119
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSHUA URRUTIA MS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/17/2025
-----------------------------------------------------
Last Update Date | 07/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1308 MUSTANG LN
-----------------------------------------------------
City | SAN MARCOS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78666-1177
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-787-1327
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1464 E WHITESTONE BLVD STE 2001
-----------------------------------------------------
City | CEDAR PARK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78613-9078
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-650-8018
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 98759
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------