Individual
DR. JOSEPH RICHARD PELLI JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
719 W COKE RD, WINNSBORO, TX 75494-3011
(903) 342-5227
Mailing address
PO BOX 841656, DALLAS, TX 75284-1656
(903) 531-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
BP10047337
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346096614
—
TX
01
—
413557YS6P
MEDICARE
TX
01
—
75-0818167-044
TRICARE
TX
01
—
75-0818167-048
TRICARE
TX
01
—
8HB331
BCBS
TX
01
—
P01912520
MEDICARE RAIL ROAD
TX
Enumeration date
05/23/2013
Last updated
03/17/2018
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