Provider Demographics
NPI:1255390357
Name:GERHARD, JEAN M (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:M
Last Name:GERHARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JEAN
Other - Middle Name:MURRAY
Other - Last Name:FERRARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6130 W PARKER RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7901
Mailing Address - Country:US
Mailing Address - Phone:972-468-8158
Mailing Address - Fax:972-473-4808
Practice Address - Street 1:3004 COMMUNICATIONS PKWY
Practice Address - Street 2:#200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8909
Practice Address - Country:US
Practice Address - Phone:972-468-8158
Practice Address - Fax:972-473-4808
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6582207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139001503Medicaid
TX139001503Medicaid