Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | F4835 | TX |
NPI | 1477651099 |
---|---|
Provider Name | David M. Gershenson |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030-4009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 13/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
116173901 | (05) | TX |
160016392 | RR MEDICARE (01) | TX |
800135 | BCBS (01) | TX |
E51238 | (02) | |
P083644F2 | (05) | TX |