Provider Demographics
NPI:1629196423
Name:T DAVID GREER MD AND ASSOCIATES
Entity Type:Organization
Organization Name:T DAVID GREER MD AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:GREET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:9405-384-3336
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:102 SOUTH ARCHER
Mailing Address - City:HENRIETTA
Mailing Address - State:TX
Mailing Address - Zip Code:76365
Mailing Address - Country:US
Mailing Address - Phone:940-538-4336
Mailing Address - Fax:940-538-6271
Practice Address - Street 1:102 SOUTH ARCHER
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:TX
Practice Address - Zip Code:76365
Practice Address - Country:US
Practice Address - Phone:940-538-4336
Practice Address - Fax:940-538-6271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0095BMMedicare ID - Type Unspecified