Provider Demographics
NPI:1225016041
Name:EHMER, DALE ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:DALE
Middle Name:ROBERT
Last Name:EHMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 UPLANDS DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3052
Mailing Address - Country:US
Mailing Address - Phone:972-517-8875
Mailing Address - Fax:
Practice Address - Street 1:3801 GASTON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1541
Practice Address - Country:US
Practice Address - Phone:214-823-9630
Practice Address - Fax:214-821-3556
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTXH9907207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX055466901Medicaid
TXF80331Medicare UPIN
TX82W102Medicare ID - Type Unspecified