Provider Demographics
NPI:1649574641
Name:QUIN A GERARD M.D.P.A.
Entity Type:Organization
Organization Name:QUIN A GERARD M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:QUIN
Authorized Official - Middle Name:ADAIR
Authorized Official - Last Name:GERARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-528-1833
Mailing Address - Street 1:3701 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-3802
Mailing Address - Country:US
Mailing Address - Phone:214-528-1833
Mailing Address - Fax:214-582-3701
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:SUITE A-310
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2584
Practice Address - Country:US
Practice Address - Phone:972-566-7777
Practice Address - Fax:972-566-7958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6234207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB135382OtherMEDICARE PTAN
TXTXB135382OtherMEDICARE PTAN