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General NPI Number Information
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NPI Number | 1245688605
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Entity Type | Organization
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Legal Business Name | GWEN H. WEBSTER, M.D. P.A.
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Dates
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Enumeration Date | 05/26/2016
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Last Update Date | 05/26/2016
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Provider Practice Location Address
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Address Line | 5940 W PARKER RD SUITE 200
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City | PLANO
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State | TX
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Zip | 75093-6439
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Country | US
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Telephone | 972-781-0249
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Fax | 972-781-0861
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Provider Business Mailing Address
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Address Line | 5940 W PARKER RD SUITE 200
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City | PLANO
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State | TX
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Zip | 75093-6439
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Country | US
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Telephone | 972-781-0249
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Fax | 972-781-0861
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Authorized Official
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Title or Position | OWNER
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Name | GWEN WEBSTER
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Credential | MD
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Telephone | 972-781-0249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K5426
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License Number State | TX
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