Provider Demographics
NPI:1477629699
Name:TOLER, GRETCHEN F (MD)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:F
Last Name:TOLER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5477 GLEN LAKES DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0978
Mailing Address - Country:US
Mailing Address - Phone:214-373-9391
Mailing Address - Fax:214-373-9303
Practice Address - Street 1:5477 GLEN LAKES DR
Practice Address - Street 2:SUITE 150
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0978
Practice Address - Country:US
Practice Address - Phone:214-373-9391
Practice Address - Fax:214-373-9303
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG84662083P0901X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110243665OtherRAILROAD MEDICARE
TX85284GOtherBLUE CROSS
TX412406ZN9PMedicare PIN
TX110243665OtherRAILROAD MEDICARE