Provider Demographics
NPI:1861688244
Name:GIZERSKY, YAKOV JOSHUA (DO)
Entity Type:Individual
Prefix:DR
First Name:YAKOV
Middle Name:JOSHUA
Last Name:GIZERSKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 HUNTERS WAY CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-5527
Mailing Address - Country:US
Mailing Address - Phone:281-794-7515
Mailing Address - Fax:
Practice Address - Street 1:602 HUNTERS WAY CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-5527
Practice Address - Country:US
Practice Address - Phone:281-794-7515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY256120207R00000X
390200000X
TXQ0918207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program