Provider Demographics
NPI:1790129716
Name:CREAR, GAIL CONDE (MD)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:CONDE
Last Name:CREAR
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 1:8230 WALNUT HILL LN STE 410
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4469
Mailing Address - Country:US
Mailing Address - Phone:214-346-0602
Mailing Address - Fax:
Practice Address - Street 1:8230 WALNUT HILL LN STE 410
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4469
Practice Address - Country:US
Practice Address - Phone:214-346-0602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-21
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10046660207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ9595OtherTEXAS MEDICAL BOARD