MEDICARE: VALERIE JEAN GORMAN 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
1	208600000X	Surgery Physician	L8353	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8BR114	OTHER	TX	BCBS
3	8M3095	OTHER	TX	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376576017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE JEAN GORMAN M.D.

Provider Business Mailing Address
First Line	:	1505 W JEFFERSON ST
Second Line	:	SUITE 165
City	:	WAXAHACHIE
State	:	TX
Zip	:	75165-2277
Country	:	US
Telephone Number	:	972-923-1457
Fax Number	:	972-923-1304

Provider Business Practice Location Address
First Line	:	1505 W JEFFERSON ST
Second Line	:	SUITE 165
City	:	WAXAHACHIE
State	:	TX
Zip	:	75165-2277
Country	:	US
Telephone Number	:	972-923-1457
Fax Number	:	972-923-1304

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	05/17/2023

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Directions to “ VALERIE JEAN GORMAN M.D.” Practice Location

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