Provider Demographics
NPI:1881991164
Name:GERID MEDICAL CONSULTANTS, P.L.L.C.
Entity type:Organization
Organization Name:GERID MEDICAL CONSULTANTS, P.L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-600-0190
Mailing Address - Street 1:23122 STARLIGHT BEACH RD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-0404
Mailing Address - Country:US
Mailing Address - Phone:832-600-0190
Mailing Address - Fax:832-437-0617
Practice Address - Street 1:20710 WESTHEIMER PKWY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6064
Practice Address - Country:US
Practice Address - Phone:832-600-0190
Practice Address - Fax:832-600-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7302174400000X
TXM2537174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty