Gary Wayne Driver, D.D.S.

Individual provider Active NPI General Practice Dentistry · Huntington, TX

NPI 1164542841 · NPPES record last updated Jan 26, 2011

Key facts

NPI
1164542841
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
15402 (TX)
Practice address
1202 N Main St
Huntington, TX 75949-8424
Phone
(936) 422-4211
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
15402TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Smilesfromrainapllc Past
since Oct 6, 2019
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 15402 TX Yes

Addresses

Primary practice location

1202 N Main St
Huntington, TX 75949-8424

Mailing address

PO Box 1078
Huntington, TX 75949-1078
Phone (936) 422-4211

Other identifiers

IdentifierTypeStateIssuer
1208209-03MedicaidTX

Other providers in Huntington, TX

All providers in Huntington, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.