Provider Demographics
NPI:1801947064
Name:ELLIOT J. GINCHANSKY, M.D., P.A.
Entity type:Organization
Organization Name:ELLIOT J. GINCHANSKY, M.D., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:GINCHANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-566-7576
Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:SUITE C530
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2505
Mailing Address - Country:US
Mailing Address - Phone:972-566-7576
Mailing Address - Fax:972-566-6177
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:SUITE C530
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-566-7576
Practice Address - Fax:972-566-6177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4847207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB22991Medicare UPIN
TX00G16PMedicare ID - Type UnspecifiedGROUP MEDICARE NUMBER