NPI Code Detail JSON Logo

1760427413 NPI number — G. GAVIN GERONDALE O.D.

NPI Number: 1760427413
Health Care Provider/Practitioner: G. GAVIN GERONDALE O.D.

Information about “1760427413” NPI (G. GAVIN GERONDALE O.D.) exists in 1760427413 in HTML format HTML  |  1760427413 in plain Text format TXT  |  1760427413 in PDF (Portable Document Format) PDF  |  1760427413 in an XML format XML  formats.

NPI Number : 1760427413 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1760427413",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GERONDALE",
    "FirstName": "G.",
    "MiddleName": "GAVIN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "O.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GERONDALE",
    "OtherFirstName": "G.",
    "OtherMiddleName": "GAVIN",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "O.D.",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "4901 CALHOUN RD",
    "SecondLineMailingAddress": "ROOM 2107",
    "MailingAddressCityName": "HOUSTON",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "77204-2020",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "713-743-2659",
    "MailingAddressFaxNumber": "713-743-6541",
    "FirstLinePracticeLocationAddress": "4901 CALHOUN RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOUSTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77204-2020",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "713-743-2659",
    "PracticeLocationAddressFaxNumber": "713-743-6541",
    "EnumerationDate": "06/17/2006",
    "LastUpdateDate": "05/27/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "174400000X",
          "TaxonomyName": "Specialist",
          "LicenseNumber": "03469TG",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "152W00000X",
          "TaxonomyName": "Optometrist",
          "LicenseNumber": "3469TG",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.