| Gordon E. Crofoot M.d., P.a. | |
|
3701 Kirby Dr Suite 1230 Houston TX 77098-3900 | |
| (713) 526-0005 | |
| (713) 524-1602 |
| Full Name | Gordon E. Crofoot M.d., P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 3701 Kirby Dr, Houston, Texas |
| Authorized Official Name and Position | Gordon E Crofoot (PRESIDENT) |
| Authorized Official Contact | 7135260005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gordon E. Crofoot M.d., P.a. 3701 Kirby Dr Suite 1230 Houston TX 77098-3900 Ph: (713) 526-0005 | Gordon E. Crofoot M.d., P.a. 3701 Kirby Dr Suite 1230 Houston TX 77098-3900 Ph: (713) 526-0005 |
| NPI Number | 1588655435 |
|---|---|
| Provider Enumeration Date | 10/31/2005 |
| Last Update Date | 02/24/2012 |
| Medicare PECOS PAC ID | 5799778254 |
|---|---|
| Medicare Enrollment ID | O20040408000525 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588655435 | NPI | - | NPPES |
| 115207602 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | E9592 (Texas) | Primary |
| Provider Name | Gordon E Crofoot |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730381005 PECOS PAC ID: 3779576244 Enrollment ID: I20120813000726 |
| Provider Name | Margaret Howell White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346651593 PECOS PAC ID: 3072829639 Enrollment ID: I20150827003139 |
| Provider Name | Derek Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669908802 PECOS PAC ID: 9032481882 Enrollment ID: I20170815000568 |
| Provider Name | Abel Moreno Flores |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164835310 PECOS PAC ID: 8325267362 Enrollment ID: I20180202001184 |
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