Provider Demographics
NPI:1720209158
Name:MORGAN, GEORGE S (CST)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:S
Last Name:MORGAN
Suffix:
Gender:M
Credentials:CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 W GUMM CT
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76085-9402
Mailing Address - Country:US
Mailing Address - Phone:817-444-1929
Mailing Address - Fax:
Practice Address - Street 1:7400 W GUMM CT
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76085-9402
Practice Address - Country:US
Practice Address - Phone:817-444-1929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical