Provider Demographics
NPI:1629722756
Name:GERBER, KATIE (DC)
Entity Type:Individual
Prefix:DR
First Name:KATIE
Middle Name:
Last Name:GERBER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 E LAMAR BLVD STE 267
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-3931
Mailing Address - Country:US
Mailing Address - Phone:573-718-9603
Mailing Address - Fax:
Practice Address - Street 1:9608 BARTLETT CIR STE 130
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-4449
Practice Address - Country:US
Practice Address - Phone:817-367-2007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor