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General NPI Number Information
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NPI Number | 1639363542
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Entity Type | Organization
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Legal Business Name | GARY A TIGGES M D P A
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 07/03/2008
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Provider Practice Location Address
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Address Line | 6300 W PARKER RD # 220
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City | PLANO
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State | TX
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Zip | 75093-8168
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Country | US
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Telephone | 972-981-8215
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Fax | 972-981-8038
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Provider Business Mailing Address
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Address Line | 6300 W PARKER RD # 220
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City | PLANO
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State | TX
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Zip | 75093-8168
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Country | US
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Telephone | 972-981-8215
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Fax | 972-981-8038
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. LISA PRATER
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Credential |
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Telephone | 972-981-8345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | J4563
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License Number State | TX
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