# GARY D GOTTFRIED MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578594982
- **Authorized official:** MR. GARY D GOTTFRIED MD (PRESIDENT)
- **Authorized official phone:** (817) 551-1304

## Contact information

- **Practice address:** 11797 SOUTH FWY, SUITE 350, BURLESON, TX 76028-7035
- **Practice address phone:** (817) 551-1304
- **Practice address fax:** (817) 551-5730
- **Mailing address:** 11797 SOUTH FWY, SUITE 350, BURLESON, TX 76028-7035
- **Mailing address phone:** (817) 551-1304
- **Mailing address fax:** (817) 551-5730

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/05/2006
- **Last updated:** 07/26/2012