Individual
GRIDER G. GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
7026 OLD KATY RD, SUITE 276, HOUSTON, TX 77024-2133
(713) 621-7436
(713) 963-9051
Mailing address
7026 OLD KATY RD, SUITE 276, HOUSTON, TX 77024-2133
(713) 621-7436
(713) 963-9051
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0102202025
VA
2085R0202X
Diagnostic Radiology Physician
Primary
L4955
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194443101
—
TX
Enumeration date
05/23/2007
Last updated
07/18/2013
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