Individual
DR. JACK CHARLES GORDON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1604 HOSPITAL PKWY, SUITE 207, BEDFORD, TX 76022-6986
(817) 283-4452
(817) 685-0897
Mailing address
1604 HOSPITAL PKWY, SUITE 207, BEDFORD, TX 76022-6986
(817) 283-4452
(817) 685-0897
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E7606
TX
Other
Enumeration date
05/01/2006
Last updated
07/08/2007
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