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General NPI Number Information
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NPI Number | 1760485502
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Entity Type | Individual
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Provider Name | ERIC J VENEGAS M.D
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 5007 PORTICO WAY
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City | MIDLAND
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State | TX
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Zip | 79707
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Country | US
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Telephone | 432-570-1113
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Fax | 432-570-4260
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Provider Business Mailing Address
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Address Line | 5007 PORTICO WAY
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City | MIDLAND
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State | TX
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Zip | 79707-3102
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Country | US
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Telephone | 432-570-1113
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Fax | 432-570-4260
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K7934
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | K7934
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License Number State | TX
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