<Unavail>

LBN: Charles R Gordon Md Pa
<Unavail> is an health care organization with primary practice located at 2737 S Broadway Ave , Tyler TX 75701-5413. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Charles R Gordon Md Pa can be contacted via phone (903) 531-0590, or through Downing, Dee via phone (903) 720-9910.

Contact Information

Primary practice address
2737 S Broadway Ave Tyler TX 75701-5413
Phone: (903) 531-0590
Fax: (903) 531-0591
Website:
Map and Directions
Authorized official contact:
Name: Downing, Dee
Phone: (903) 720-9910

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 28882 Texas

Profile Details

NPI number 1346670726
LBN Legal business name Charles R Gordon Md Pa
DBA Doing business as <Unavail>
Authorized official Downing, Dee
Entity Organization
Organization subpart 1 No
Enumeration date Nov 20th, 2013
Last updated Feb 20th, 2017 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346670726 NPPES
Other 2143181 PK

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