Individual
ERIC JEROME GOURLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 SCOTT AND WHITE DR, COLLEGE STATION, TX 77845-6440
(979) 207-4000
(979) 207-4562
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
K8179
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
612858
—
SC
Enumeration date
06/04/2006
Last updated
08/19/2020
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