Grebennikov, Vladimir Alexandrovich
Grebennikov, Vladimir Alexandrovich is an sole proprietor health care provider with primary practice located at 870 N Coit Rd Suite 2660, Richardson TX 75080-5420. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Grebennikov, Vladimir Alexandrovich can be contacted via phone (972) 235-2459.Contact Information
Primary practice address
870 N Coit Rd Suite 2660
Richardson TX 75080-5420
Phone: (972) 235-2459
Fax: (972) 235-9435
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | K9291 | Texas |
Profile Details
| NPI number | 1952399313 |
|---|---|
| LBN Legal business name | Grebennikov, Vladimir Alexandrovich |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 11th, 2005 |
| Last updated | Jul 25th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952399313 | NPPES |
| Texas | Other | K9291 | LICENSE |
| Texas | MEDICAID | 1504755-01 | LICENSE |
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