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General NPI Number Information
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NPI Number | 1861033631
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Entity Type | Organization
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Legal Business Name | GD TX PLLC
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Dates
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Enumeration Date | 10/03/2019
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Last Update Date | 10/03/2019
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Provider Practice Location Address
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Address Line | 26795 US HIGHWAY 380 E STE 400
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City | AUBREY
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State | TX
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Zip | 76227-7895
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Country | US
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Telephone | 972-347-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 1467 BENT TREE DR
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City | FRISCO
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State | TX
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Zip | 75036-7893
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Country | US
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Telephone | 972-814-8144
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MARCIA LOCKE
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Credential |
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Telephone | 972-814-8144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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