Individual
GERARD J VENTURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
409 RUSSELL BLVD STE B, NACOGDOCHES, TX 75965
(936) 569-0050
(936) 569-1483
Mailing address
409 RUSSELL BLVD STE B, NACOGDOCHES, TX 75965-1248
(936) 569-0050
(936) 569-1483
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
G9680
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0978744-02
—
TX
01
—
752307652
COMMERCIAL INSURANCE
—
01
—
830007888
RAILROAD MEDICARE
TX
Enumeration date
10/04/2005
Last updated
12/12/2018
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