Organization
GORDON B. STROM,JR. MD FACP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON B STROM JR. MD (MD)
(903) 785-8480
Entity
Organization
Contact information
Practice address
2850 LEWIS LN, STE. 111, PARIS, TX 75460-9378
(903) 785-8480
(903) 785-8455
Mailing address
2850 LEWIS LN, STE. 111, PARIS, TX 75460-9378
(903) 785-8480
(903) 785-8455
Taxonomy
Speciality
Code
Description
License number
State
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
F0027
TX
207R00000X
Internal Medicine Physician
Primary
F0027
TX
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
F0027
TX
363AM0700X
Medical Physician Assistant
PA030704
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00TU80
BLUE CROSS BLUE SHIELD
TX
05
—
100071470A
—
OK
05
—
160367201
—
TX
01
—
CK8750
MEDICARE RAILROAD
TX
Enumeration date
10/23/2007
Last updated
11/11/2008
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