Individual
GARY DEAN EASTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 16TH ST, GREELEY, CO 80631-5154
(970) 392-2026
(970) 392-2027
Mailing address
14269 RR 2338, GEORGETOWN, TX 78633-4112
(254) 371-1060
(254) 288-8875
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
D8202
TX
208800000X
Urology Physician
Primary
D8202
TX
208800000X
Urology Physician
DR-38516
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156562401
—
TX
Enumeration date
12/29/2005
Last updated
03/11/2015
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