Provider Demographics
NPI:1215508239
Name:GAYLAN DASCANIO, MD, PLLC
Entity type:Organization
Organization Name:GAYLAN DASCANIO, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GAYLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DASCANIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-243-5437
Mailing Address - Street 1:2005 TAWAKONI DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-4806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4100 ALPHA RD STE 650
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-4381
Practice Address - Country:US
Practice Address - Phone:972-243-5437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty