Individual
MR. GARY P. FAIRCHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OCCUPATIONAL THERAPY
Contact information
Practice address
5026 DEEPWOOD CIR, CORPUS CHRISTI, TX 78415-2901
(361) 664-9675
(361) 664-1100
Mailing address
5026 DEEPWOOD CIR, CORPUS CHRISTI, TX 78415-2901
(361) 664-9675
(361) 664-1100
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105397
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8T3278
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/13/2006
Last updated
08/18/2010
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