Provider Demographics
NPI:1316944234
Name:GROSS, ROBERT DAVID (MBA, MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DAVID
Last Name:GROSS
Suffix:
Gender:M
Credentials:MBA, MD
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Mailing Address - Street 1:7150 GREENVILLE AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-5185
Mailing Address - Country:US
Mailing Address - Phone:214-369-6434
Mailing Address - Fax:214-696-6273
Practice Address - Street 1:7150 GREENVILLE AVE STE 305
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5185
Practice Address - Country:US
Practice Address - Phone:214-369-6434
Practice Address - Fax:214-696-6273
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF4025207W00000X, 207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00K89JOtherBLUE CROSS BLUE SHIELD
TX751384272OtherPEDIATRIC OPHTHALMOLOGY, PA
TX1114050242OtherPEDIATRIC OPHTHALMOLOGY, PA GROUP NPI
B74233Medicare UPIN