<Unavail>

LBN: Charles R Gordon Md Pa
<Unavail> is an health care organization with primary practice located at 2737 S Broadway Ave , Tyler TX 75701-5445. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Neurological Surgery, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Neurological Surgery is the primary health care specialty. Charles R Gordon Md Pa can be contacted via phone (903) 592-6000, or through Gordon, Charles R via phone (903) 592-6000.

Contact Information

Primary practice address
2737 S Broadway Ave Tyler TX 75701-5445
Phone: (903) 592-6000
Fax: (903) 595-1592
Website:
Map and Directions
Authorized official contact:
Name: Gordon, Charles R Doctor of Medicine (MD)
Phone: (903) 592-6000

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1982717955
LBN Legal business name Charles R Gordon Md Pa
DBA Doing business as <Unavail>
Authorized official Gordon, Charles R Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 16th, 2006
Last updated Sep 22nd, 2026 - about 2 months 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 1982717955 NPPES
Other 0023KV BLUE CROSS BLUE SHIELD

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