Provider Demographics
NPI:1144548025
Name:GENE A DEVORA MD PHD PA
Entity type:Organization
Organization Name:GENE A DEVORA MD PHD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GENE
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:DEVORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD/PHD
Authorized Official - Phone:214-207-0846
Mailing Address - Street 1:6300 W PARKER RD STE G22
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8105
Mailing Address - Country:US
Mailing Address - Phone:972-981-3692
Mailing Address - Fax:972-981-3605
Practice Address - Street 1:6300 W PARKER RD STE 220
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8168
Practice Address - Country:US
Practice Address - Phone:972-981-8215
Practice Address - Fax:972-981-3605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-17
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6587207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty