Provider Demographics
NPI:1649232141
Name:SZABO, GRETA (MD)
Entity Type:Individual
Prefix:DR
First Name:GRETA
Middle Name:
Last Name:SZABO
Suffix:
Gender:F
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:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-0595
Mailing Address - Fax:214-645-0596
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7201
Practice Address - Country:US
Practice Address - Phone:214-645-0595
Practice Address - Fax:214-645-0596
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1308207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00334977OtherMEDICARE RAILROAD
KY64122062Medicaid
000000392179OtherANTHEM
KY1349109Medicare ID - Type Unspecified
000000392179OtherANTHEM
I61735Medicare UPIN
IN200844150Medicaid