Provider Demographics
NPI:1518040757
Name:OCKER, GERALD R (DDS)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:R
Last Name:OCKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 WEST SIXTH
Mailing Address - Street 2:
Mailing Address - City:RUSK
Mailing Address - State:TX
Mailing Address - Zip Code:75785-0000
Mailing Address - Country:US
Mailing Address - Phone:903-683-5158
Mailing Address - Fax:903-683-5158
Practice Address - Street 1:971 W 6TH ST
Practice Address - Street 2:
Practice Address - City:RUSK
Practice Address - State:TX
Practice Address - Zip Code:75785-1184
Practice Address - Country:US
Practice Address - Phone:903-683-5158
Practice Address - Fax:903-683-5158
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX137891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice