MEDICARE: DR. JOSEPH MICHAEL CARUSO M.D.

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	208600000X	Surgery Physician	2386621	NY
2	2086S0129X	Vascular Surgery Physician	N7589	TX
3	2086S0129X	Vascular Surgery Physician	2386621	NY
4	2086S0129X	Vascular Surgery Physician	N7529	TX

General Provider Information

NPI Number	:	1619901584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH MICHAEL CARUSO M.D.

Provider Business Mailing Address
First Line	:	515 W MAYFIELD RD STE 416
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-2085
Country	:	US
Telephone Number	:	817-375-0300
Fax Number	:	817-375-0301

Provider Business Practice Location Address
First Line	:	515 W MAYFIELD RD STE 416
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-2085
Country	:	US
Telephone Number	:	817-375-0300
Fax Number	:	817-375-0301

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	09/12/2024

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