Individual
GERARDO QUEZADA
Active
Individual
GERARDO QUEZADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
M7544
TX
208000000X
Pediatrics Physician
M7544
TX
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
M7544
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191616505
—
TX
01
—
191616506
CSHCN
TX
01
—
8BX396
BCBS TX
—
01
—
8F10114
MEDICARE
TX
Enumeration date
02/21/2008
Last updated
03/09/2012
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