Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | F-6477 | TX |
NPI | 1013971910 |
---|---|
Provider Name | Dr. Gerald Edward Brenton |
First Address | Cuero, TX 77954-5004 |
Second Address | Cuero, TX 77954-5004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B47589 | (02) | TX |