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NPI Code Detail

MEDICARE: GARRY LYNN GORE MD

MEDICARE:   GARRY LYNN GORE  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianK2909TX

Other Identifiers

General Provider Information

NPI Number : 1144278227
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARRY LYNN GORE MD
Provider Business Mailing Address
First Line : 8406 SPRING CRK
Second Line :
City : COLLEGE STATION
State : TX
Zip : 77845-4607
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1604 ROCK PRAIRIE RD
Second Line :
City : COLLEGE STATION
State : TX
Zip : 77845-8345
Country : US
Telephone Number : 979-764-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 10/22/2012

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Directions to “ GARRY LYNN GORE MD” Practice Location

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