Healthcare Provider Details

I. General information

NPI: 1376572867
Provider Name (Legal Business Name): GREGORY NORMAN MESSNER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4708 DEXTER DR STE 350
PLANO TX
75093-5288
US

IV. Provider business mailing address

6717 COLUMBINE WAY
PLANO TX
75093-6347
US

V. Phone/Fax

Practice location:
  • Phone: 469-750-8041
  • Fax: 469-750-3057
Mailing address:
  • Phone: 469-750-8041
  • Fax: 469-750-3057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberK5159
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberK5159
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberK5159
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: