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1861454654

NPI Code Detail

MEDICARE: DR. JEFFERY LYNN GUBBELS MD

MEDICARE: DR. JEFFERY LYNN GUBBELS 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
1	207V00000X	Obstetrics & Gynecology Physician	H2422	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	160018958	OTHER	TX	RAILROAD GBA - RAILROAD MEDICARE
2	P01090488	OTHER	TX	RAILROAD MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	82C362	OTHER	TX	BC/BS TX#
6	8DE528	OTHER	TX	BC/BS #

General Provider Information

NPI Number	:	1861454654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFERY LYNN GUBBELS MD

Provider Business Mailing Address
First Line	:	2100 REGIONAL MEDICAL DR
Second Line	:
City	:	WHARTON
State	:	TX
Zip	:	77488-9719
Country	:	US
Telephone Number	:	979-532-1700
Fax Number	:	979-532-6790

Provider Business Practice Location Address
First Line	:	2100 REGIONAL MEDICAL DR
Second Line	:
City	:	WHARTON
State	:	TX
Zip	:	77488-9719
Country	:	US
Telephone Number	:	979-532-1700
Fax Number	:	979-532-6790

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	12/05/2012

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1861456550 — DR. HENRY J. LOPEZ-ROMAN MD
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1710941034 — DR. FERNANDO ANTONIO SALAZAR MD
Practice Location Address:

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Directions to “ DR. JEFFERY LYNN GUBBELS MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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