Individual
GORDON BERTRAM STROM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1055 CLARKSVILLE ST, STE 195, PARIS, TX 75460-6097
(903) 785-8480
(903) 785-8455
Mailing address
1055 CLARKSVILLE ST, STE 195, PARIS, TX 75460-6097
(903) 785-8480
(903) 785-8455
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
F0027
TX
207R00000X
Internal Medicine Physician
Primary
F0027
TX
208M00000X
Hospitalist Physician
F0027
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00TU80
MEDICARE RAILROAD
TX
05
—
100071470A
—
OK
05
—
100280005
—
TX
Enumeration date
06/20/2005
Last updated
09/14/2016
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