Provider Demographics
NPI:1205864667
Name:JOSEPH, ROY M (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:M
Last Name:JOSEPH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7610 N STEMMONS FWY STE 600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4228
Mailing Address - Country:US
Mailing Address - Phone:214-689-5960
Mailing Address - Fax:469-713-8084
Practice Address - Street 1:3324 COLORADO BOUVELARD
Practice Address - Street 2:SUITE 101
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210
Practice Address - Country:US
Practice Address - Phone:940-243-7200
Practice Address - Fax:940-565-1577
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3266207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0029CHOtherBC/BS
TX214637501Medicaid
TX029534701Medicaid
TX0A0272Medicare PIN
TX0029CHOtherBC/BS
TX029534701Medicaid
TX00084DMedicare PIN