Provider Demographics
NPI:1083607907
Name:VENECIA, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:VENECIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:613 ELIZABETH ST
Mailing Address - Street 2:605
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2220
Mailing Address - Country:US
Mailing Address - Phone:361-883-6211
Mailing Address - Fax:361-882-4891
Practice Address - Street 1:613 ELIZABETH ST
Practice Address - Street 2:605
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2220
Practice Address - Country:US
Practice Address - Phone:361-883-6211
Practice Address - Fax:361-882-4891
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH0903207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139659001Medicaid
TXB27286Medicare UPIN
TX81V596Medicare ID - Type Unspecified