Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | F5887 | TX |
N | 207T00000X | Neurosurgeon | MD14313 | DC |
NPI | 1093818221 |
---|---|
Provider Name | Gary C Dennis |
First Address | Frisco, TX 75035-0225 |
Second Address | Plano, TX 75024-3279 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 19/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8CU230 | BCBS (01) | TX |
A49643 | (02) |