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General NPI Number Information
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NPI Number | 1588655435
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Entity Type | Organization
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Legal Business Name | GORDON E. CROFOOT M.D., P.A.
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 02/24/2012
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Provider Practice Location Address
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Address Line | 3701 KIRBY DR SUITE 1230
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City | HOUSTON
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State | TX
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Zip | 77098-3900
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Country | US
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Telephone | 713-526-0005
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Fax | 713-524-1602
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Provider Business Mailing Address
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Address Line | 3701 KIRBY DR SUITE 1230
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City | HOUSTON
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State | TX
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Zip | 77098-3900
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Country | US
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Telephone | 713-526-0005
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Fax | 713-524-1602
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Authorized Official
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Title or Position | PRESIDENT
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Name | GORDON E CROFOOT JR.
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Credential | M.D.
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Telephone | 713-526-0005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | E9592
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License Number State | TX
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