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NPI Code Detail

MEDICARE: NATHANIEL DUNCAN GERON PA-C

MEDICARE:   NATHANIEL DUNCAN GERON  PA-C
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
1363AM0700XMedical Physician AssistantPA09725TX
2363AS0400XSurgical Physician AssistantPA09725TX
3363A00000XPhysician AssistantPA09725TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2455224YV3COTHERTXMEDICARE P-TAN USP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA09725OTHERTXSTATE LICENSE

General Provider Information

NPI Number : 1942688684
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHANIEL DUNCAN GERON PA-C
Provider Business Mailing Address
First Line : 3899 SOUTHWEST FWY
Second Line :
City : HOUSTON
State : TX
Zip : 77027-7515
Country : US
Telephone Number : 832-323-9230
Fax Number :
Provider Business Practice Location Address
First Line : 3899 SOUTHWEST FWY
Second Line :
City : HOUSTON
State : TX
Zip : 77027-7515
Country : US
Telephone Number : 832-323-9230
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2015
Last Update Date : 06/06/2022

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Directions to “ NATHANIEL DUNCAN GERON PA-C” Practice Location

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