Gordon, Martyn D
Gordon, Martyn D is an individual health care provider with primary practice located at 1604 Lancaster Dr , Grapevine TX 76051. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Gordon, Martyn D can be contacted via phone (817) 481-8661.Contact Information
Primary practice address
1604 Lancaster Dr
Grapevine TX 76051
Phone: (817) 481-8661
Fax: (817) 416-8801
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | G5101 | Texas |
Profile Details
| NPI number | 1972689750 |
|---|---|
| LBN Legal business name | Gordon, Martyn D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2006 |
| Last updated | Jun 28th, 2022 - about 2 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 | 1972689750 | NPPES |
| Texas | MEDICAID | 0354078 |
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