Individual
GERARDO MEDEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 W TERRELL AVE STE K230, FORT WORTH, TX 76104-2820
(817) 250-4906
(817) 250-1815
Mailing address
1300 W TERRELL AVE STE K230, FORT WORTH, TX 76104-2820
(817) 250-4906
(817) 250-1815
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
T3665
TX
Other
Enumeration date
04/19/2018
Last updated
10/05/2021
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