Provider Demographics
NPI:1609484120
Name:JOHN R. GILMORE, M.D.
Entity Type:Organization
Organization Name:JOHN R. GILMORE, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANCIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-239-0343
Mailing Address - Street 1:10740 N CENTRAL EXPY STE 120
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-2162
Mailing Address - Country:US
Mailing Address - Phone:214-361-5285
Mailing Address - Fax:469-941-4272
Practice Address - Street 1:10740 N CENTRAL EXPY STE 120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2162
Practice Address - Country:US
Practice Address - Phone:214-361-5285
Practice Address - Fax:469-941-4272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-21
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty