Provider Demographics
NPI:1609882596
Name:GORDON, DEMPSEY D (DO)
Entity Type:Individual
Prefix:
First Name:DEMPSEY
Middle Name:D
Last Name:GORDON
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:7430 REMCON CIR
Mailing Address - Street 2:SUITE B-110
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3514
Mailing Address - Country:US
Mailing Address - Phone:915-544-2455
Mailing Address - Fax:915-544-3149
Practice Address - Street 1:9870 GATEWAY BLVD N
Practice Address - Street 2:STE B-7
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-4425
Practice Address - Country:US
Practice Address - Phone:915-751-5245
Practice Address - Fax:915-751-5255
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-08-22
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Provider Licenses
StateLicense IDTaxonomies
TXH0392207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA66614Medicare UPIN