Provider Demographics
NPI:1912983289
Name:MCWHORTER, GREGORY W (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:W
Last Name:MCWHORTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5516 WEATHERBY LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-3417
Mailing Address - Country:US
Mailing Address - Phone:214-577-7635
Mailing Address - Fax:972-612-5811
Practice Address - Street 1:5516 WEATHERBY LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3417
Practice Address - Country:US
Practice Address - Phone:214-577-7635
Practice Address - Fax:972-612-5811
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5406207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8227M8OtherBCBS
TX148622703Medicaid
TX148622702Medicaid
TX148622705OtherMEDICAID CSHCN
TX148622701Medicaid
TX148622704OtherMEDICAID CSHCN
TX148622705OtherMEDICAID CSHCN
TX148622702Medicaid
TXTXB107523Medicare PIN
F76798Medicare UPIN
TX8B4304Medicare PIN