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General NPI Number Information
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NPI Number | 1629432000
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Entity Type | Individual
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Provider Name | DAVID TIMOTHY GORRELL MD
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Gender | Male
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Dates
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Enumeration Date | 04/11/2016
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 5323 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75390-2017
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Country | US
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Telephone | 214-648-2717
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 845347
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City | DALLAS
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State | TX
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Zip | 75284-5347
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0101274663
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301506279
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | R8197
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License Number State | TX
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