Provider Demographics
NPI:1376572867
Name:MESSNER, GREGORY NORMAN (DO)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:NORMAN
Last Name:MESSNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6717 COLUMBINE WAY
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6347
Mailing Address - Country:US
Mailing Address - Phone:469-750-8041
Mailing Address - Fax:469-750-3057
Practice Address - Street 1:4708 DEXTER DR STE 350
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5288
Practice Address - Country:US
Practice Address - Phone:469-750-8041
Practice Address - Fax:469-750-3057
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5159207P00000X, 2086S0129X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U9393OtherBCBS
TX149924601Medicaid
TXP00715572OtherRR MEDICARE PIN
TXK5159OtherMEDICAL LICENSE
TX8F21268Medicare PIN
TXP00715572OtherRR MEDICARE PIN