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General NPI Number Information
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NPI Number | 1104095363
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Entity Type | Organization
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Legal Business Name | GERALD B MCCOOL DPM
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Dates
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Enumeration Date | 02/21/2008
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 6955 N MESA ST SUITE 301
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City | EL PASO
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State | TX
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Zip | 79912-4442
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Country | US
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Telephone | 915-581-1133
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Fax | 915-581-9656
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Provider Business Mailing Address
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Address Line | 6955 N MESA ST SUITE 301
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City | EL PASO
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State | TX
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Zip | 79912-4442
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Country | US
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Telephone | 915-581-1133
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Fax | 915-581-9656
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Authorized Official
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Title or Position | PODIATRIST
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Name | GERALD BRIAN MCCOOL
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Credential | DPM
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Telephone | 915-581-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0916
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License Number State | TX
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