Provider Demographics
NPI:1689657298
Name:ECHT, GREGORY A (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:A
Last Name:ECHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7415 LAS COLINAS BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-7568
Mailing Address - Country:US
Mailing Address - Phone:214-379-2700
Mailing Address - Fax:972-869-3875
Practice Address - Street 1:7415 LAS COLINAS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063
Practice Address - Country:US
Practice Address - Phone:214-379-2700
Practice Address - Fax:972-869-3875
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-29
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH68092085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0985095Medicaid
TX8F3274Medicare PIN
E43908Medicare UPIN
TX0985095Medicaid