Provider Demographics
NPI:1457398935
Name:DEVINNEY, DENNIS SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:SCOTT
Last Name:DEVINNEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9477
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75711-9477
Mailing Address - Country:US
Mailing Address - Phone:903-594-2450
Mailing Address - Fax:903-509-0493
Practice Address - Street 1:700 OLYMPIC PLAZA CIR
Practice Address - Street 2:SUITE 600
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-1951
Practice Address - Country:US
Practice Address - Phone:903-596-3844
Practice Address - Fax:903-596-3843
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7355207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00059858OtherRAILROAD MEDICARE
TX8J8312OtherBLUE CROSS
TX8A9881Medicare PIN
TXP00059858Medicare PIN
TXP00059858OtherRAILROAD MEDICARE
H55973Medicare UPIN