Provider Demographics
NPI:1770760555
Name:C. GILBERT FALKE, M.D. AND ASSOCIATES
Entity type:Organization
Organization Name:C. GILBERT FALKE, M.D. AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:GILBERT
Authorized Official - Last Name:FALKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-374-2634
Mailing Address - Street 1:PO BOX 765268
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75376-5268
Mailing Address - Country:US
Mailing Address - Phone:214-374-2634
Mailing Address - Fax:214-374-0300
Practice Address - Street 1:814 MISTY GLEN LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75232-1608
Practice Address - Country:US
Practice Address - Phone:214-374-2634
Practice Address - Fax:214-374-0300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2013-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6012208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00Z580Medicare PIN