| White Rock Internal Medicine | |
|
9330 Poppy Dr Suite 403 Dallas TX 75218-4621 | |
| (214) 328-4389 | |
| (214) 328-4085 |
| Full Name | White Rock Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 9330 Poppy Dr, Dallas, Texas |
| Authorized Official Name and Position | Gary A Croll (PARTNER) |
| Authorized Official Contact | 2143284389 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| White Rock Internal Medicine 9330 Poppy Dr Suite 403 Dallas TX 75218-4621 Ph: (214) 328-4389 | White Rock Internal Medicine 9330 Poppy Dr Suite 403 Dallas TX 75218-4621 Ph: (214) 328-4389 |
| NPI Number | 1508074113 |
|---|---|
| Provider Enumeration Date | 05/18/2007 |
| Last Update Date | 01/31/2008 |
| Medicare PECOS PAC ID | 1658394598 |
|---|---|
| Medicare Enrollment ID | O20080821000288 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508074113 | NPI | - | NPPES |
| 1134288012 | Other | TX | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Cynthia R Muller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689695561 PECOS PAC ID: 7315920980 Enrollment ID: I20040612000707 |
| Provider Name | Gary A Croll |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962445916 PECOS PAC ID: 8729001664 Enrollment ID: I20100802000834 |
| Provider Name | Jose Vallejos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427239409 PECOS PAC ID: 3870892755 Enrollment ID: I20160427001119 |
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