Individual provider Active NPI

Johnny L Gates, MD

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1790853133
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
F5208 Issued in TX
Practice address
707 N Zang Blvd
Suite 2
Dallas, TX 75208-4337
Phone
(214) 941-7467
Fax
(214) 946-1123
NPI assigned
Dec 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Internal Medicine Physician 207R00000X F5208 TX Primary

Addresses

Primary practice location

707 N Zang Blvd
Suite 2
Dallas, TX 75208-4337

Mailing address

707 N Zang Blvd
Suite 2
Dallas, TX 75208-4337
Phone (214) 941-7467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921000457 TX Practitioner - Internal Medicine 4587647532 Practice locations: Dallas, TX

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Creighton University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

655 Wynnewood Village SHP Ctr
Suite 267
Dallas, TX 75224-1830
Phone (214) 941-7467

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F5208TXMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790853133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 N ZANG BLVD",
            "address_2": "SUITE 2",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752084337",
            "telephone_number": "214-941-7467",
            "fax_number": "214-946-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N ZANG BLVD",
            "address_2": "SUITE 2",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752084337",
            "telephone_number": "214-941-7467",
            "fax_number": "214-946-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "JOHNNY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "F5208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.