Provider Demographics
NPI:1588073613
Name:PERSHWITZ, GENE (MD)
Entity type:Individual
Prefix:
First Name:GENE
Middle Name:
Last Name:PERSHWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 WATTERS CREEK BLVD BLDG M
Mailing Address - Street 2:SUITE 250 PMB #0301
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3770
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1205 CRESTWICK DR
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4142
Practice Address - Country:US
Practice Address - Phone:214-233-5949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-02
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE30257208M00000X
CT62078207R00000X
CT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine