Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | N3609 | TX |
Y | 207YS0123X | Facial Plastic Surgeon | N3609 | TX |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | N3609 | TX |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | N3609 | TX |
NPI | 1063632974 |
---|---|
Provider Name | Joshua Charles Demke |
First Address | Lubbock, TX 79408-5865 |
Second Address | Lubbock, TX 79430-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 02/12/2021 |