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General NPI Number Information
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NPI Number | 1417240656
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Entity Type | Organization
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Legal Business Name | JEFFREY P GAITZ MDPA
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Dates
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Enumeration Date | 05/20/2011
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Last Update Date | 05/20/2011
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Provider Practice Location Address
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Address Line | 1740 W 27TH ST STE 206
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City | HOUSTON
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State | TX
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Zip | 77008-1433
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Country | US
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Telephone | 713-861-6555
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Fax | 713-861-4589
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Provider Business Mailing Address
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Address Line | 1740 W 27TH ST STE 206
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City | HOUSTON
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State | TX
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Zip | 77008-1433
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Country | US
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Telephone | 713-861-6555
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Fax | 713-861-4589
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | MR. JEFFREY P GAITZ
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Credential | M.D.
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Telephone | 713-861-6555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | E9070
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License Number State | TX
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