Individual
DR. JERRY ALAN BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
714 CALM CREST DR, ROCKWALL, TX 75087-6454
(972) 974-2952
Mailing address
714 CALM CREST DR, ROCKWALL, TX 75087-6454
(972) 974-2952
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01063076A
IN
2084N0400X
Neurology Physician
01063076A
IN
2084N0400X
Neurology Physician
Primary
300857
LA
390200000X
Student in an Organized Health Care Education/Training Program
01063076A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01063076A
PHYSICIAN LICENSE
IN
01
—
300857
LOUISIANA PHYSICIAN LICENSE
LA
Enumeration date
01/05/2007
Last updated
01/27/2016
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