Provider Demographics
NPI:1255619268
Name:GISPANSKI, ROBERT LEE (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEE
Last Name:GISPANSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4613 VISTA GRANDE
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-0010
Mailing Address - Country:US
Mailing Address - Phone:972-467-1836
Mailing Address - Fax:469-535-3499
Practice Address - Street 1:4401 N I 35 UNIT 312
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76207-3318
Practice Address - Country:US
Practice Address - Phone:940-381-1501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4052207Q00000X
OK5080207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine