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Individual

DR. GREGORY ANDREW TICHENOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 HOSPITAL PKWY, BEDFORD, TX 76022-6913
(817) 848-4000
Mailing address
P O BOX 960046, OKLAHOMA CITY, OK 73196-0001
(877) 485-4474

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J9391
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
132071503
TX
01
85V309
BCBS THRU HEB
TX
01
930047705
RAILROAD MCARE THRU HEB
TX
Enumeration date
02/23/2006
Last updated
12/31/2014
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