Provider Demographics
NPI:1225140270
Name:GELVEZ, JAVIER (MD)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:GELVEZ
Suffix:
Gender:M
Credentials:MD
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 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:801 7TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2733
Practice Address - Country:US
Practice Address - Phone:682-885-4868
Practice Address - Fax:682-885-7956
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL22752080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1750369203OtherGRP NPI NUMBER
TX124203OtherSUPERIOR PIN
TX8170416OtherCIGNA PIN
TX9187588OtherPHCS PIN
TX00U87ZOtherBCBSTX GRP PIN
TX130817100OtherFIRSTCARE PIN
TX1971499OtherFIRSTHEALTH PIN
TX2138377OtherUHC PIN
TX146265704OtherCSHCN
TX8B7180OtherBCBSTX IND PIN
TX10030777OtherAMERIGROUP PIN
TX146265703Medicaid
TX7025306OtherAETNA PIN
TX9187588OtherPHCS PIN
TX146265704OtherCSHCN