Provider Demographics
NPI:1457314536
Name:GEMAS, TERRY KEITH (MD)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:KEITH
Last Name:GEMAS
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 1:1130 BEACHVIEW ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3700
Mailing Address - Country:US
Mailing Address - Phone:469-341-5676
Mailing Address - Fax:469-341-5677
Practice Address - Street 1:1130 BEACHVIEW ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3700
Practice Address - Country:US
Practice Address - Phone:469-341-5676
Practice Address - Fax:469-341-5677
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2276207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7081295OtherAETNA
TX610541200OtherDEPARTMENT OD LABOR
TX5475440001OtherPALMETTO
TX8CM465OtherBCBS
00035ZOtherMEDICARE GROUP
TXMDL2276OtherWORK COMP
TN151314502Medicaid
TXG73066Medicare UPIN
TN151314502Medicaid
00035ZOtherMEDICARE GROUP