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NPI Code Detail

MEDICARE: DR. RAY COOKE GILLESPIE D.D.S.

MEDICARE:  DR. RAY COOKE GILLESPIE  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223E0200XEndodontics13181TX

General Provider Information

NPI Number : 1396949632
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAY COOKE GILLESPIE D.D.S.
Provider Business Mailing Address
First Line : 6700 HARRIS PKWY
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-4104
Country : US
Telephone Number : 817-361-0929
Fax Number : 817-361-0930
Provider Business Practice Location Address
First Line : 6700 HARRIS PKWY
Second Line :
City : FORT WORTH
State : TX
Zip : 76132-4104
Country : US
Telephone Number : 817-361-0929
Fax Number : 817-361-0930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2007
Last Update Date : 07/08/2007

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Directions to “ DR. RAY COOKE GILLESPIE D.D.S.” Practice Location

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