Provider Demographics
NPI:1578540753
Name:GURPINAR, EDIZ I (MD)
Entity Type:Individual
Prefix:DR
First Name:EDIZ
Middle Name:I
Last Name:GURPINAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:EDIZ
Other - Middle Name:IBRAHIM
Other - Last Name:GURPINAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1302 N STATE HWY 91
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-1167
Mailing Address - Country:US
Mailing Address - Phone:903-465-1857
Mailing Address - Fax:903-327-8023
Practice Address - Street 1:5016 S US HIGHWAY 75
Practice Address - Street 2:RADIOLOGY DEPT
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75020-0890
Practice Address - Country:US
Practice Address - Phone:903-416-4000
Practice Address - Fax:903-327-8023
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9294174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX105131003Medicaid
TXH21601Medicare UPIN
TX105131003Medicaid