Provider Demographics
NPI:1407891989
Name:ROY M JOSEPH, MD, P.A.
Entity Type:Organization
Organization Name:ROY M JOSEPH, MD, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:M
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-243-7200
Mailing Address - Street 1:3324 COLORADO BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6890
Mailing Address - Country:US
Mailing Address - Phone:940-243-7200
Mailing Address - Fax:940-565-1577
Practice Address - Street 1:3324 COLORADO BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6890
Practice Address - Country:US
Practice Address - Phone:940-243-7200
Practice Address - Fax:940-565-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0029CHOtherBC/BS
TX029534701Medicaid
TX00084DMedicare PIN
TX100016379Medicare PIN