=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578515797
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GREGORY N ROHN MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/16/2006
-----------------------------------------------------
Last Update Date | 01/18/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6300 W PARKER RD
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75093-8104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-378-0633
-----------------------------------------------------
Fax | 972-378-0656
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8230 WALNUT HILL LN STE 420
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75231-4482
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-265-0800
-----------------------------------------------------
Fax | 214-265-1027
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | H8358
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------