Organization
PALO PINTO EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH H. GATEWOOD M.D. (PRESIDENT)
(214) 712-2000
Entity
Organization
Contact information
Practice address
400 SW 25TH AVE, MINERAL WELLS, TX 76067
(940) 325-7891
(214) 712-2487
Mailing address
PO BOX 7267, PHILADELPHIA, PA 19101-7267
(800) 355-3818
(214) 712-2487
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012NR
BLUE SHIELD
TX
Enumeration date
06/07/2006
Last updated
04/20/2008
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