Individual
CHERYL D GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2606 HOSPITAL BLVD, CORPUS CHRISTI, TX 78405-1833
(361) 902-6200
Mailing address
919 HIDDEN RDG, IRVING, TX 75038-3813
(469) 282-2711
(469) 282-0996
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP122070
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1L5650
MEDICARE
TX
05
—
341510101
—
TX
05
—
341510102
—
TX
01
—
P02601755
MCRR
TX
Enumeration date
07/24/2012
Last updated
04/09/2021
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