Provider Demographics
NPI:1356856702
Name:GREER, GORDON SCOTT
Entity Type:Individual
Prefix:MR
First Name:GORDON
Middle Name:SCOTT
Last Name:GREER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5475 HIGHWAY 105
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77708-3800
Mailing Address - Country:US
Mailing Address - Phone:409-892-8840
Mailing Address - Fax:409-892-2633
Practice Address - Street 1:5475 HIGHWAY 105
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77708-3800
Practice Address - Country:US
Practice Address - Phone:409-892-8840
Practice Address - Fax:409-892-2633
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80313237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist