Provider Demographics
NPI:1164760039
Name:MORRIS, GERALD DWAYNE II (CPNP)
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:DWAYNE
Last Name:MORRIS
Suffix:II
Gender:M
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W BLUFF ST
Mailing Address - Street 2:
Mailing Address - City:WOODVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75979-4734
Mailing Address - Country:US
Mailing Address - Phone:409-283-2090
Mailing Address - Fax:409-283-2097
Practice Address - Street 1:900 W BLUFF ST
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:TX
Practice Address - Zip Code:75979-4734
Practice Address - Country:US
Practice Address - Phone:409-283-2090
Practice Address - Fax:409-283-2097
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX746539363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics