Healthcare Provider Details

I. General information

NPI: 1184693475
Provider Name (Legal Business Name): GREGORY SINCLAIR GOLDSMITH SR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 07/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E SAVANNAH AVE BLDG B, STE 101
MCALLEN TX
78503-1241
US

IV. Provider business mailing address

110 E SAVANNAH AVE BLDG B, STE 101
MCALLEN TX
78503-1241
US

V. Phone/Fax

Practice location:
  • Phone: 956-686-1575
  • Fax: 956-686-8542
Mailing address:
  • Phone: 956-686-1575
  • Fax: 956-686-8542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberF9482
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: