Individual
JOSEPH PERNISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6451 BRENTWOOD STAIR RD STE 200, FORT WORTH, TX 76112-3200
(817) 507-1769
Mailing address
687 FINLEY CT, DALLAS, TX 75208-1267
(503) 560-6893
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
S2462
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2017
Last updated
05/30/2021
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