MEDICARE: JOEL JOSELEVITZ M.D.

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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	J1703	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00J89E	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861433567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL JOSELEVITZ M.D.

Provider Business Mailing Address
First Line	:	3139 W HOLCOMBE BLVD STE 705
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-1533
Country	:	US
Telephone Number	:	713-532-9421
Fax Number	:	713-532-9443

Provider Business Practice Location Address
First Line	:	2219 DORRINGTON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-3209
Country	:	US
Telephone Number	:	713-669-1670
Fax Number	:	713-669-1671

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

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	10/14/2021

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