Gideon, Jerry K

Gideon, Jerry K is an individual health care provider with primary practice located at 120 E Harris Ave , San Angelo TX 76903-5904. He recently has only one registered license in Allopathic & Osteopathic Physicians / Blood Banking & Transfusion Medicine, which is considered as his primary health care specialty. Gideon, Jerry K can be contacted via phone (325) 658-1511.

Contact Information

Primary practice address
120 E Harris Ave San Angelo TX 76903-5904
Phone: (325) 658-1511
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Blood Banking & Transfusion Medicine 207ZB0001X H6236 Texas

Profile Details

NPI number 1629053384
LBN Legal business name Gideon, Jerry K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2005
Last updated Aug 15th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629053384 NPPES
Texas MEDICAID 118290905

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