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1093808180

NPI Code Detail

MEDICARE: JOYCE E MAUK MD

MEDICARE: JOYCE E MAUK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0008X	Pediatric Neurodevelopmental Disabilities Physician	K6134	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	118781100	OTHER	TX	FIRSTCARE PIN
4	1548230923	OTHER		GRP NPI NUMBER
5	10024054	OTHER	TX	AMERIGROUP PIN
6	4416581	OTHER	TX	AETNA PIN
7	0026CV	OTHER	TX	BCBSTX GRP PIN
8	1840371	OTHER	TX	UHC PIN
9	43655	OTHER	TX	FIRSTHEALTH PIN
10	492577	OTHER	TX	PHCS PIN
11	4338797	OTHER	TX	CIGNA PIN
12	124160	OTHER	TX	SUPERIOR PIN
13	82861S	OTHER	TX	BCBSTX IND PIN

General Provider Information

NPI Number	:	1093808180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCE E MAUK MD

Provider Business Mailing Address
First Line	:	1300 W LANCASTER
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76102-3484
Country	:	US
Telephone Number	:	817-336-2823
Fax Number	:	682-885-7347

Provider Business Practice Location Address
First Line	:	1300 W LANCASTER AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76102-3410
Country	:	US
Telephone Number	:	817-336-8611
Fax Number	:	682-336-2823

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	02/05/2010

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Directions to “ JOYCE E MAUK MD” Practice Location

Language	Start Address	Practice Location

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