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Individual
DR. RONNIE GENTRY
Active
Individual
DR. RONNIE GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J4147
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8CN638
BLUE CROSS BLUE SHIELD
TX
01
—
8EF364
BLUE CROSS BLUE SHIELD
TX
01
—
8V4451
BCBS
TX
01
—
P00333634
RR MEDICARE
—
01
—
P00892884
RR MEDICARE
TX
Enumeration date
12/15/2005
Last updated
03/21/2016
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