Provider Demographics
NPI:1821006834
Name:W GREGORY LENSING MD PA
Entity Type:Organization
Organization Name:W GREGORY LENSING MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:W
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:LENSING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-596-9511
Mailing Address - Street 1:5501 INDEPENDENCE PKWY
Mailing Address - Street 2:#203
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023
Mailing Address - Country:US
Mailing Address - Phone:972-596-9511
Mailing Address - Fax:972-867-8163
Practice Address - Street 1:5501 INDEPENDENCE PKWY
Practice Address - Street 2:#203
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023
Practice Address - Country:US
Practice Address - Phone:972-596-9511
Practice Address - Fax:972-867-8163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0054BVMedicare PIN