| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JOE B VENTIMIGLIA | 1083647945 | 2024-01-07 |
Joe B Ventimiglia MD [M] graduated in 1993 from Duke University School Of Medicine and primarily specializes in Family Medicine.
Joe B Ventimiglia is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1083647945. Registration indicates Joe B Ventimiglia is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Family Medicine Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine, Allopathic & Osteopathic Physicians)
| PECOS ID | 3274436563 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Joe B Ventimiglia M.D., PH.D. |
| Practice Office Address | 6350 DAVIS BLVD # 200 NORTH RICHLAND , TX US |
| Practice Office Telephone | 9725259900 |
| Mailing Address | 1611 PHEASANT LN SOUTHLAKE, TX 760923436 US |
| Business Telephone | 9729838915 |
| Business Fax | 8177615365 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 5001 Ross Ave # 120 | Dallas, TX 752067706 | 9725259900 / 4693337988 |
| 6350 Davis Blvd # 200 | North Richland Hills, TX 761804762 | 9725259900 |
| 7165 Colleyville Blvd Ste 102 | Colleyville, TX 760348010 | 8177784048 / 8177615365 |
| Village Medical Texas [] | [email protected] |
| Code | Practice | License No State |
|---|---|---|
| 207Q00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Family MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Family Medicine Allopathic & Osteopathic Physicians Family Medicine Family Medicine Primary Care/Family Planning/APRN/PA Family Medicine Allopathic & Osteopathic Physicians | K0231
TX |
| 133567102 | MEDICAID | TX | |
| K0231 | OTHER | TX | STATE MD LICENS |
| 133567109 | MEDICAID | TX |