Provider Demographics
NPI:1093818221
Name:DENNIS, GARY C (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:C
Last Name:DENNIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 6020
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0225
Mailing Address - Country:US
Mailing Address - Phone:972-377-9200
Mailing Address - Fax:972-377-9300
Practice Address - Street 1:7150 PRESTON RD
Practice Address - Street 2:BLDG 3, SUITE 300
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3279
Practice Address - Country:US
Practice Address - Phone:214-705-9599
Practice Address - Fax:214-705-9590
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD14313207T00000X
TXF5887207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CU230OtherBCBS
TXTXB141319Medicare PIN
A49643Medicare UPIN
TXTXB141319Medicare PIN