Provider Demographics
NPI:1023013166
Name:HOFFMAN, GERALD EDWARD (DO)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:EDWARD
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 421209
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77242-1209
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13111 EAST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-5820
Practice Address - Country:US
Practice Address - Phone:713-481-3541
Practice Address - Fax:713-432-0221
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4857207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX220018814OtherRAILROAD MEDICARE
TX220009429OtherRAILROAD M/C-NEPG
TX83P471Medicare PIN
TX80P566Medicare PIN
TX220009429OtherRAILROAD M/C-NEPG