Provider Demographics
NPI:1932148442
Name:NAOUM, JOSEPH JOE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JOE
Last Name:NAOUM
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 1:2060 SPACE PARK DR STE 112
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3674
Mailing Address - Country:US
Mailing Address - Phone:281-523-2363
Mailing Address - Fax:
Practice Address - Street 1:2060 SPACE PARK DR STE 112
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058
Practice Address - Country:US
Practice Address - Phone:281-523-2363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7069208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1932148442OtherRAILROAD MEDICARE
TX160246803Medicaid
TX8P8711OtherBLUE CROSS BLUE SHIELD
TX160246804Medicaid
TX8J5361Medicare PIN
TX8P8711OtherBLUE CROSS BLUE SHIELD