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General NPI Number Information
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NPI Number | 1164083010
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Entity Type | Organization
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Legal Business Name | JESSE GORLEY, M.D., PLLC
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1411 9TH ST.
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4302
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Country | US
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Telephone | 940-386-9041
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Fax | 940-448-3298
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Provider Business Mailing Address
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Address Line | 1411 9TH ST.
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4302
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Country | US
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Telephone | 940-386-9041
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Fax | 940-448-3298
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JESSE DAVID GORLEY
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Credential | M.D.
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Telephone | 940-386-9041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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