1962739524 NPI number — KATHERINE M GERBER RD

Table of content: ALLISON ZILONIS (NPI 1942801642)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962739524 NPI number — KATHERINE M GERBER RD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GERBER
Provider First Name:
KATHERINE
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962739524
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6431 FANNIN ST
Provider Second Line Business Mailing Address:
DEPT.OF INTERNAL MEDICINE, MCGOVERN MEDICAL SCHOOL
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77030-1501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-500-6500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23923 CINCO RANCH BLVD
Provider Second Line Business Practice Location Address:
UT PHYSICIANS
Provider Business Practice Location Address City Name:
KATY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77494-3399
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-486-5347
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/03/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  DT05625 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DT05625 . This is a "STATE LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 22220180 . This is a "NCBDE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 865357 . This is a "COMMISSION ON DIETETIC REGISTRATION" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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