=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881761575
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN ANDERSON GERLING D.D.S.,M.S.D.,PA.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4900 N 10TH ST STE F2
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78504-2781
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-687-2004
-----------------------------------------------------
Fax | 956-631-6614
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4900 N 10TH ST STE F2
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78504-2781
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-687-2004
-----------------------------------------------------
Fax | 956-631-6614
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number | 13084
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------