MEDICARE: MICHAEL VENINCASA 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	207RC0000X	Cardiovascular Disease Physician	H3614	TX
2	207RC0000X	Cardiovascular Disease Physician	083029	CT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	060026137	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	88K981	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1790728178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL VENINCASA MD

Provider Business Mailing Address
First Line	:	500 LA VIDA CT
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-6565
Country	:	US
Telephone Number	:	214-356-3594
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 LA VIDA CT
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-6565
Country	:	US
Telephone Number	:	972-449-0540
Fax Number	:	972-449-0550

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

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	01/20/2026

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Directions to “ MICHAEL VENINCASA MD” Practice Location

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