Provider Demographics
NPI:1245434869
Name:MAYORGA, GILBERT JR (MD)
Entity type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:
Last Name:MAYORGA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6910 BELLAIRE BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-3546
Mailing Address - Country:US
Mailing Address - Phone:713-772-5840
Mailing Address - Fax:713-772-5841
Practice Address - Street 1:6910 BELLAIRE BLVD STE 8
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-3546
Practice Address - Country:US
Practice Address - Phone:713-772-5840
Practice Address - Fax:713-772-5841
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH3117208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC18999Medicare UPIN