Provider Demographics
NPI:1740629419
Name:GATOURA, GEORGIA M (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGIA
Middle Name:M
Last Name:GATOURA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 WESTHEIMER RD
Mailing Address - Street 2:3A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1284
Mailing Address - Country:US
Mailing Address - Phone:713-529-6318
Mailing Address - Fax:713-529-9787
Practice Address - Street 1:2701 WESTHEIMER RD
Practice Address - Street 2:3A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1284
Practice Address - Country:US
Practice Address - Phone:713-529-6318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0202172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker