Organization
CHANDOR EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH H. GATEWOOD MD (PRESIDENT)
(214) 712-2000
Entity
Organization
Contact information
Practice address
713 E ANDERSON ST, WEATHERFORD, TX 76086-5705
(817) 341-2273
Mailing address
1717 MAIN ST, #5200, DALLAS, TX 75201-4612
(214) 712-2000
(214) 712-2444
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0055QQ
BLUE SHIELD
TX
Enumeration date
10/04/2007
Last updated
04/20/2008
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