Provider Demographics
NPI:1720040413
Name:PAPPAS, GREGORY ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ALEXANDER
Last Name:PAPPAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 GOLDEN AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414-3121
Mailing Address - Country:US
Mailing Address - Phone:979-323-9900
Mailing Address - Fax:979-323-0997
Practice Address - Street 1:1701 GOLDEN AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:TX
Practice Address - Zip Code:77414-3121
Practice Address - Country:US
Practice Address - Phone:979-323-9900
Practice Address - Fax:979-323-0997
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8306207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097000602Medicaid
TX097000602Medicaid
TX00890LMedicare ID - Type Unspecified