Provider Demographics
NPI:1750107686
Name:HIGHTOWER, GERRID D
Entity type:Individual
Prefix:MR
First Name:GERRID
Middle Name:D
Last Name:HIGHTOWER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 DERBY CIR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-2917
Mailing Address - Country:US
Mailing Address - Phone:817-965-1049
Mailing Address - Fax:
Practice Address - Street 1:VA NORTH TEXAS HEALTH CARE SYSTEM
Practice Address - Street 2:4500 S. LANCASTER RD.
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216
Practice Address - Country:US
Practice Address - Phone:214-742-8387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic