Provider Demographics
NPI:1508939653
Name:RONNIE W DENNIS MD, PC
Entity Type:Organization
Organization Name:RONNIE W DENNIS MD, PC
Other - Org Name:SWEETWATER OBSTETRICS & GYNECOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:325-235-1888
Mailing Address - Street 1:301 JENNY GEORGE LN
Mailing Address - Street 2:STE 5
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556
Mailing Address - Country:US
Mailing Address - Phone:325-235-1888
Mailing Address - Fax:325-235-1889
Practice Address - Street 1:301 JENNY GEORGE LN
Practice Address - Street 2:STE 5
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-7152
Practice Address - Country:US
Practice Address - Phone:325-235-1888
Practice Address - Fax:325-235-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7533207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCC604519326Medicare PIN