Provider Demographics
NPI:1295702090
Name:BELLOMO, JOSEPH F (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:BELLOMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 E OVILLA RD STE 600
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-3896
Mailing Address - Country:US
Mailing Address - Phone:469-437-3344
Mailing Address - Fax:844-292-1456
Practice Address - Street 1:307 E. OLIVE ROAD
Practice Address - Street 2:SUITE 600
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154
Practice Address - Country:US
Practice Address - Phone:469-437-3344
Practice Address - Fax:844-292-1456
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2987207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125304905Medicaid
TX125304902Medicaid
TX125304902Medicaid
TX8L6741Medicare PIN
TX85G118Medicare PIN