Healthcare Provider Details

I. General information

NPI: 1225016041
Provider Name (Legal Business Name): DALE ROBERT EHMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 GASTON AVE SUITE 200
DALLAS TX
75246-1541
US

IV. Provider business mailing address

1904 UPLANDS DR
PLANO TX
75025-3052
US

V. Phone/Fax

Practice location:
  • Phone: 214-823-9630
  • Fax: 214-821-3556
Mailing address:
  • Phone: 972-517-8875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberTXH9907
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: