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Individual

MICHAEL B GROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6124 W PARKER RD, SUITE 434, PLANO, TX 75093-8122
(214) 691-1902
(214) 987-1845
Mailing address
3600 GASTON AVE, SUITE 1205, DALLAS, TX 75246-1800
(214) 692-8262
(214) 696-4190

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
H8091
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
118934201
TX
05
118934202
TX
01
340016189
RRMCR
TX
01
340016194
RRMCR OTHER
TX
01
80403X
BCBS PROVIDER ID
Enumeration date
05/27/2006
Last updated
01/31/2017
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