Individual
DR. JOHN REEVES GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Mailing address
5002 COWHORN CREEK RD, TEXARKANA, TX 75503-9766
(903) 614-3000
(903) 614-3525
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G2379
TX
174400000X
Specialist
L#014100
LA
174400000X
Specialist
R3021
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103414001
—
AR
05
—
114062601
—
TX
01
—
19284
OKLAHOMA MEDICAL LICENSE
OK
01
—
40048923
TEXAS CONTROLLED SUB. LIC
TX
01
—
G2379
TX STATE MEDICAL LICENSE
TX
01
—
L#014100
LOUISIANA MEDICAL LICENSE
LA
01
—
R-3021
ARKANSAS MEDICAL LICENSE
AR
Enumeration date
09/30/2005
Last updated
03/07/2023
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