Provider Demographics
NPI:1518077742
Name:APPELT, GARY L (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:L
Last Name:APPELT
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 1:633 MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833-5412
Mailing Address - Country:US
Mailing Address - Phone:979-830-1014
Mailing Address - Fax:979-836-9103
Practice Address - Street 1:633 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-5412
Practice Address - Country:US
Practice Address - Phone:979-830-1014
Practice Address - Fax:979-836-9103
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2443208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035336901Medicaid
TX00PF13Medicare ID - Type Unspecified
TX035336901Medicaid