Individual
ADOLPHUS V GIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
828 KIRKWOOD DR, DALLAS, TX 75218-2208
(214) 328-0518
(214) 328-0518
Mailing address
828 KIRKWOOD DR, DALLAS, TX 75218-2208
(214) 328-0518
(214) 328-0518
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L7731
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168406007
—
TX
Enumeration date
07/26/2006
Last updated
08/22/2014
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