Individual
GREGORY ALAN REDISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9330 POPPY DR, STE 405, DALLAS, TX 75218-4621
(214) 320-9382
(214) 321-1137
Mailing address
9330 POPPY DR, STE 405, DALLAS, TX 75218-4621
(214) 320-9382
(214) 321-1137
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G2006
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060031201
RAILROAD MEDICARE
TX
01
—
060035084
RAILROAD MEDICARE
TX
05
—
128832602
—
TX
05
—
128832604
—
TX
05
—
128832605
—
TX
01
—
80A138
BCBS
TX
01
—
81G602
BCBS
TX
Enumeration date
09/16/2005
Last updated
04/12/2018
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