Provider Demographics
NPI:1578340535
Name:NGX G GERBER PC
Entity Type:Organization
Organization Name:NGX G GERBER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT SERVICE CENTER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GRACIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-261-9418
Mailing Address - Street 1:5901 W WACO DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-6356
Mailing Address - Country:US
Mailing Address - Phone:361-208-6062
Mailing Address - Fax:361-208-6062
Practice Address - Street 1:5901 W WACO DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-6356
Practice Address - Country:US
Practice Address - Phone:361-208-6062
Practice Address - Fax:361-208-6062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty