Organization
GARY D GOTTFRIED MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY D GOTTFRIED MD (PRESIDENT)
(817) 551-1304
Entity
Organization
Contact information
Practice address
11797 SOUTH FWY, SUITE 350, BURLESON, TX 76028-7035
(817) 551-1304
(817) 551-5730
Mailing address
11797 SOUTH FWY, SUITE 350, BURLESON, TX 76028-7035
(817) 551-1304
(817) 551-5730
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201953101
—
TX
05
—
201953102
—
TX
Enumeration date
07/05/2006
Last updated
07/26/2012
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