Healthcare Provider Details

I. General information

NPI: 1083711964
Provider Name (Legal Business Name): IRENE GELMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IRINA GELMAN M.D.

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 04/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 MEDICAL CENTER BLVD
CONROE TX
77304-2808
US

IV. Provider business mailing address

PO BOX 946
MONTGOMERY TX
77356-0946
US

V. Phone/Fax

Practice location:
  • Phone: 713-269-5483
  • Fax: 281-256-6673
Mailing address:
  • Phone: 713-269-5483
  • Fax: 281-256-6673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberM1108
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberM1108
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: