Individual
GERALD H FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4400 BUFFALO GAP RD, SUITE 2250, ABILENE, TX 79606-2723
(325) 793-5380
(325) 793-5259
Mailing address
PO BOX 5409, ABILENE, TX 79608-5409
(325) 793-5380
(325) 793-5259
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
038581
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86009U
BCBSTX
TX
05
—
C088724C5
—
TX
01
—
P00342697
MEDICARE ID
TX
Enumeration date
10/19/2005
Last updated
01/02/2008
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