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General NPI Number Information
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NPI Number | 1891961298
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Entity Type | Individual
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Provider Name | GORDON KEITH ROSS FNP-C
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Gender | Male
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Dates
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Enumeration Date | 05/06/2008
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 9708 BUSINESS PKWY STE 118
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City | HELOTES
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State | TX
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Zip | 78023-4742
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Country | US
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Telephone | 210-372-9898
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Fax |
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Provider Business Mailing Address
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Address Line | 11634 FOXFORD
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City | SAN ANTONIO
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State | TX
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Zip | 78253-6026
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Country | US
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Telephone | 210-771-9688
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 662304
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 662304
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 662304
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 662304
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License Number State | TX
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