Gary R. Mennie, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

K9128 Issued in TX

Legal business name

GARY R. MENNIE, M.D.

Practice address

2770 Aero Drive
Suite 1
Port Arthur, TX 77640

Phone

(409) 727-4642

Fax

(409) 721-9774

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gary Roy Mennie, M.D.NPI 1235131210

Title

Owner

Phone

(409) 727-4642

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gary Roy Mennie, M.D.

  • Specialist
  • Port Arthur, TX
  • NPI 1235131210
  NPD (past) Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1457441503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 AERO DRIVE",
            "address_2": "SUITE 1",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77640",
            "telephone_number": "409-727-4642",
            "fax_number": "409-721-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 AERO DRIVE",
            "address_2": "SUITE 1",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77640",
            "telephone_number": "409-727-4642",
            "fax_number": "409-721-9774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY R. MENNIE, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "MENNIE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-727-4642",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "K9128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.