Active NPI
Gregory Roy Istre, M.D.
- Pediatric Infectious Diseases Physician
- Carrollton, TX
National Provider Identifier
1336128057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Infectious Diseases Physician
- License
- J0536
- Practice address
- 4014 Crestwood Dr
Carrollton, TX 75007-1645 - Phone
- (214) 855-8510
- NPI assigned
- Jan 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Infectious Diseases Physician | 2080P0208X | J0536 | TX | Primary |
Addresses
Primary practice location
4014 Crestwood Dr
Carrollton, TX 75007-1645
Mailing address
PO Box 795275
Dallas, TX 75379-5275
Phone (214) 855-8510
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89311K | Other | TX | BCBS |
| 100826250B | Medicaid | OK | |
| 136229507 | Medicaid | TX |
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
| License | State | Type | Specialty |
|---|---|---|---|
| J0536 | TX | MD | Pediatric Infectious Diseases Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pid Associates, P.a. | Pediatric Infectious Diseases | Past | Accepting new patients |
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.
-
- Pediatric Infectious Diseases Physician
- Carrollton, TX
- NPI 1902885809
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328227200000",
"number": "1336128057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 795275",
"city": "DALLAS",
"state": "TX",
"postal_code": "753795275",
"telephone_number": "214-855-8510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4014 CRESTWOOD DR",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750071645",
"telephone_number": "214-855-8510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ISTRE",
"first_name": "GREGORY",
"middle_name": "ROY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-11",
"last_updated": "2012-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "TX",
"license": "J0536",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "89311K",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100826250B",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "136229507",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carrollton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.