Individual
MR. JOE PARKER TAIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1201 W FRANK AVE, LUFKIN, TX 75904-3357
(936) 639-7900
Mailing address
419 PR 7028, JEFFERSON, TX 75657-5938
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
670098
TX
163W00000X
Registered Nurse
68603-02995
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
47271
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1687243
—
TX
Enumeration date
11/08/2005
Last updated
11/04/2022
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