MEDICARE: DR. PATRICIA A GUM MD

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	207RI0011X	Interventional Cardiology Physician	L6408	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134183874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA A GUM MD

Provider Business Mailing Address
First Line	:	16980 DALLAS PKWY
Second Line	:	SUITE 200
City	:	DALLAS
State	:	TX
Zip	:	75248-1908
Country	:	US
Telephone Number	:	972-391-1915
Fax Number	:	972-391-2061

Provider Business Practice Location Address
First Line	:	1640 COIT RD
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-6163
Country	:	US
Telephone Number	:	972-985-8838
Fax Number	:	972-596-1724

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	07/09/2010

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