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NPI Code Detail

MEDICARE: DR. GREGORY JAY ELDERS MD

MEDICARE:  DR. GREGORY JAY ELDERS  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XS0117XOrthopaedic Surgery of the Spine PhysicianL8677TX
2207X00000XOrthopaedic Surgery PhysicianL8677TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2L8677OTHERTXLICENSE

General Provider Information

NPI Number : 1669479861
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY JAY ELDERS MD
Provider Business Mailing Address
First Line : 508 MEDICAL CENTER BLVD # 360
Second Line :
City : CONROE
State : TX
Zip : 77304-2953
Country : US
Telephone Number : 936-756-2229
Fax Number : 844-274-2115
Provider Business Practice Location Address
First Line : 508 MEDICAL CENTER BLVD # 360
Second Line :
City : CONROE
State : TX
Zip : 77304-2953
Country : US
Telephone Number : 936-756-2229
Fax Number : 844-274-2115
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2005
Last Update Date : 04/12/2023

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Directions to “ DR. GREGORY JAY ELDERS MD” Practice Location

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