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NPI Code Detail

MEDICARE: MICHAEL B GROSS M.D.

MEDICARE: MICHAEL B GROSS 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
1208800000XUrology PhysicianH8091TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
180403XOTHERBCBS PROVIDER ID
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3340016189OTHERTXRRMCR
4340016194OTHERTXRRMCR OTHER
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447207493
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL B GROSS M.D.
Provider Business Mailing Address
First Line : 3600 GASTON AVE
Second Line : SUITE 1205
City : DALLAS
State : TX
Zip : 75246-1800
Country : US
Telephone Number : 214-692-8262
Fax Number : 214-696-4190
Provider Business Practice Location Address
First Line : 6124 W PARKER RD
Second Line : SUITE 434
City : PLANO
State : TX
Zip : 75093-8122
Country : US
Telephone Number : 214-691-1902
Fax Number : 214-987-1845
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2006
Last Update Date : 01/31/2017

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