Provider Demographics
NPI:1164607693
Name:RONALD P. GIOMETTI JR., M.D. P.A.
Entity Type:Organization
Organization Name:RONALD P. GIOMETTI JR., M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:GIOMETTI
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:972-394-9478
Mailing Address - Street 1:4325 N JOSEY LN STE 105
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4636
Mailing Address - Country:US
Mailing Address - Phone:972-394-9478
Mailing Address - Fax:972-394-7656
Practice Address - Street 1:4325 N JOSEY LN STE 105
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4636
Practice Address - Country:US
Practice Address - Phone:972-394-9478
Practice Address - Fax:972-394-7656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9285207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty