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General NPI Number Information
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NPI Number | 1861526352
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Entity Type | Organization
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Legal Business Name | JOSEPH T. TRETTA, DO, PA
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 123 MEDICAL DR STE A
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City | PALESTINE
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State | TX
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Zip | 75801-8507
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Country | US
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Telephone | 903-723-9009
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Fax | 903-723-0236
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Provider Business Mailing Address
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Address Line | 123 MEDICAL DR STE A
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City | PALESTINE
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State | TX
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Zip | 75801-8507
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Country | US
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Telephone | 903-723-9009
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Fax | 903-723-0236
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Authorized Official
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Title or Position | NURSE
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Name | MRS. CONNIE J TRETTA
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Credential |
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Telephone | 903-723-9009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | F7643
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License Number State | TX
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