Individual
JOE NIETO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1140 BUSINESS CENTER DR, HOUSTON, TX 77043-2737
(800) 617-7717
Mailing address
10867 CAMINO CIR, WELLINGTON, FL 33414-9303
(561) 827-2170
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G88921
CA
207P00000X
Emergency Medicine Physician
K8382
TX
207P00000X
Emergency Medicine Physician
ME0077039
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204612002
—
TX
05
—
204612003
—
TX
05
—
260869300
—
FL
01
—
51914
BCBS
FL
01
—
P00094695
RAILROAD MEDICARE
—
Enumeration date
03/08/2006
Last updated
10/31/2023
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