Provider Demographics
NPI:1346467586
Name:GARY C MORCHOWER MD
Entity Type:Organization
Organization Name:GARY C MORCHOWER MD
Other - Org Name:GARY C MORCHOWER MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORCHOWER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-231-2551
Mailing Address - Street 1:1112 N FLOYD RD
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4243
Mailing Address - Country:US
Mailing Address - Phone:972-231-2551
Mailing Address - Fax:972-852-6002
Practice Address - Street 1:1112 N FLOYD RD
Practice Address - Street 2:SUITE 6A
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4243
Practice Address - Country:US
Practice Address - Phone:972-231-2551
Practice Address - Fax:972-852-6002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3653208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX099549001Medicaid
TX099549001Medicaid