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Individual
JOEL RUSSEL MAUST
Active
Individual
JOEL RUSSEL MAUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J6570
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00U61E
MEDICARE GROUP NUMBER
TX
05
—
155581501
—
TX
01
—
155581503
MEDICAID OTHER
TX
Enumeration date
06/01/2006
Last updated
04/21/2022
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