Provider Demographics
NPI:1013202407
Name:WASSERMAN, GILBERT TYLER SR (ATP)
Entity Type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:TYLER
Last Name:WASSERMAN
Suffix:SR
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 SKYWAY CIR N
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3509
Mailing Address - Country:US
Mailing Address - Phone:972-358-9813
Mailing Address - Fax:877-398-3449
Practice Address - Street 1:2930 SKYWAY CIR N
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-3509
Practice Address - Country:US
Practice Address - Phone:972-358-9813
Practice Address - Fax:877-398-3449
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other