Organization
GARY A. OGIN, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA DAVIDOVICH (ADMINISTRATOR)
(214) 232-1300
Entity
Organization
Contact information
Practice address
700 E SOUTHLAKE BLVD, STE. 130, SOUTHLAKE, TX 76092-6353
(817) 421-9111
Mailing address
363 W FORK, APT. 1215, IRVING, TX 75039-6229
(817) 421-9111
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
G9176
TX
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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