Provider Demographics
NPI:1598085854
Name:VINE, GERILYNN SALMERON (MD)
Entity Type:Individual
Prefix:
First Name:GERILYNN
Middle Name:SALMERON
Last Name:VINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 FANNIN ST
Mailing Address - Street 2:SUITE 755
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1920
Mailing Address - Country:US
Mailing Address - Phone:713-658-0358
Mailing Address - Fax:713-658-9414
Practice Address - Street 1:7400 FANNIN ST
Practice Address - Street 2:SUITE 755
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1920
Practice Address - Country:US
Practice Address - Phone:713-658-0358
Practice Address - Fax:713-658-9414
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP9128207V00000X
TXBP10037821207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology