Provider Demographics
NPI:1861631327
Name:GULF COAST SPINAL MONITORING PLLC
Entity Type:Organization
Organization Name:GULF COAST SPINAL MONITORING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KEEPERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-487-7722
Mailing Address - Street 1:308 W PARKWOOD AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5478
Mailing Address - Country:US
Mailing Address - Phone:832-487-7722
Mailing Address - Fax:713-943-0167
Practice Address - Street 1:308 W PARKWOOD AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5478
Practice Address - Country:US
Practice Address - Phone:832-487-7722
Practice Address - Fax:713-943-0167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty