Provider Demographics
NPI:1366545873
Name:ISOM-BATZ, GINGER (MD)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:ISOM-BATZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GINGER
Other - Middle Name:
Other - Last Name:ISOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3600 GASTON AVE
Mailing Address - Street 2:SUITE 1205
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:214-692-8262
Mailing Address - Fax:214-696-4190
Practice Address - Street 1:10501 N. CENTRAL EXPWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2200
Practice Address - Country:US
Practice Address - Phone:214-360-1535
Practice Address - Fax:214-360-1534
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4197208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FW629OtherBCBS
TX489772YNEDMedicare PIN
TX8FW629OtherBCBS
TX489772YND4Medicare PIN