Provider Demographics
NPI:1003044322
Name:GAFFORD, CASSIDY ANN (MD)
Entity Type:Individual
Prefix:
First Name:CASSIDY
Middle Name:ANN
Last Name:GAFFORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CASSIDY
Other - Middle Name:ANN
Other - Last Name:DURAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8210 WALNUT HILL LN STE 505
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4420
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8210 WALNUT HILL LN STE 505
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4420
Practice Address - Country:US
Practice Address - Phone:214-345-4160
Practice Address - Fax:214-345-4165
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ73582086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX358727101Medicaid