Healthcare Provider Details
I. General information
NPI: 1508386822
Provider Name (Legal Business Name): GPCH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/27/2017
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
50 MEDICAL DR STE 200
BORGER TX
79007-4406
US
IV. Provider business mailing address
100 MEDICAL DR
BORGER TX
79007-7579
US
V. Phone/Fax
- Phone: 806-467-5350
- Fax: 806-275-9282
- Phone: 806-467-5350
- Fax: 806-275-9282
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DONALD
EARL
BATES
JR.
Title or Position: CEO
Credential:
Phone: 806-467-5700