Provider Demographics
NPI:1912957499
Name:CARTWRIGHT, GREGORY BRYAN (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:BRYAN
Last Name:CARTWRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2712 NORWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-1247
Mailing Address - Country:US
Mailing Address - Phone:817-897-0687
Mailing Address - Fax:817-897-0687
Practice Address - Street 1:3109 6TH AVE STE A
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-3800
Practice Address - Country:US
Practice Address - Phone:817-923-7055
Practice Address - Fax:817-923-7902
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7544207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH7544OtherLICENSE
TX613858Medicare PIN
TX860238Medicare PIN
TXH7544OtherLICENSE