MEDICARE: V GARY PRICE 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	208800000X	Urology Physician	E9920	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750377727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	V GARY PRICE MD

Provider Business Mailing Address
First Line	:	811 W INTERSTATE 20
Second Line	:	SUITE G22
City	:	ARLINGTON
State	:	TX
Zip	:	76017-5870
Country	:	US
Telephone Number	:	817-784-8268
Fax Number	:	817-804-8176

Provider Business Practice Location Address
First Line	:	811 W INTERSTATE 20
Second Line	:	SUITE G22
City	:	ARLINGTON
State	:	TX
Zip	:	76017-5870
Country	:	US
Telephone Number	:	817-784-8268
Fax Number	:	817-804-8176

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	06/14/2016

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Directions to “ V GARY PRICE MD” Practice Location

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