Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | J7277 | TX |
NPI | 1174566624 |
---|---|
Provider Name | Dr. Thomas F. Gregory |
First Address | Dallas, TX 75391-1230 |
Second Address | Tyler, TX 75702-8369 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 18/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8R1599 | BLUE CROSS OF TEXAS (01) | TX |
G16038 | (02) | TX |