MEDICARE: GARY C DENNIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	MD14313	DC
2	207T00000X	Neurological Surgery Physician	F5887	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8CU230	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1093818221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY C DENNIS M.D.

Provider Business Mailing Address
First Line	:	PO BOX 6020
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-0225
Country	:	US
Telephone Number	:	972-377-9200
Fax Number	:	972-377-9300

Provider Business Practice Location Address
First Line	:	7150 PRESTON RD
Second Line	:	BLDG 3, SUITE 300
City	:	PLANO
State	:	TX
Zip	:	75024-3279
Country	:	US
Telephone Number	:	214-705-9599
Fax Number	:	214-705-9590

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	04/19/2017

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Directions to “ GARY C DENNIS M.D.” Practice Location

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