=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508051871
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALVIN R. GEBERT, MD, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/10/2007
-----------------------------------------------------
Last Update Date | 04/02/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6130 W PARKER RD SUITE 412
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75093-7901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-608-8889
-----------------------------------------------------
Fax | 972-473-2322
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6130 W PARKER RD SUITE 412
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75093-7901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-608-8889
-----------------------------------------------------
Fax | 972-473-2322
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ALVIN RAY GEBERT
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 972-608-8889
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | E6083
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------