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NPI Code Detail

MEDICARE: DR. GERARD VALLEJO M.D.

MEDICARE: DR. GERARD VALLEJO M.D.
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
12084P0800XPsychiatry PhysicianL5936TX

General Provider Information

NPI Number : 1285029538
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERARD VALLEJO M.D.
Provider Business Mailing Address
First Line : 379 FM 2972 W
Second Line :
City : RUSK
State : TX
Zip : 75785-3666
Country : US
Telephone Number : 903-683-5781
Fax Number :
Provider Business Practice Location Address
First Line : 379 FM 2972 W
Second Line :
City : RUSK
State : TX
Zip : 75785-3666
Country : US
Telephone Number : 903-683-5781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2015
Last Update Date : 04/03/2015

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Directions to “ DR. GERARD VALLEJO M.D.” Practice Location

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