MEDICARE: DR. JOSEPH WILLIAM DRIVER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	72626	TN
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207P00000X	Emergency Medicine Physician	W7017	TX

General Provider Information

NPI Number	:	1700578234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH WILLIAM DRIVER MD

Provider Business Mailing Address
First Line	:	4055 INTERNATIONAL PLZ STE 230
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-4874
Country	:	US
Telephone Number	:	817-496-9700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1105 CENTRAL EXPY N
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-6103
Country	:	US
Telephone Number	:	972-747-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2023
Last Update Date	:	06/16/2026

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