Individual provider Active NPI

Gregory Steven Rab, MD

  • Emergency Medicine Physician
  • Dallas, TX
National Provider Identifier
1124007646
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G3057 Issued in TX
Practice address
5560 Andalusia Ave
Dallas, TX 75248-6450
Phone
(972) 980-0658
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G3057 TX Primary

Addresses

Primary practice location

5560 Andalusia Ave
Dallas, TX 75248-6450

Mailing address

5560 Andalusia Ave
Dallas, TX 75248-6450
Phone (972) 980-0658

Other identifiers 1

IdentifierTypeStateIssuer
8A0469OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G3057TXMDEmergency Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124007646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5560 ANDALUSIA AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752486450",
            "telephone_number": "972-980-0658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5560 ANDALUSIA AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752486450",
            "telephone_number": "972-980-0658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAB",
        "first_name": "GREGORY",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "G3057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8A0469",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.