Provider Demographics
NPI:1699703983
Name:TAMEZ, GILBERT G (LAT, ATC, CSCS)
Entity type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:G
Last Name:TAMEZ
Suffix:
Gender:M
Credentials:LAT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 COCHRAN LN
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:TX
Mailing Address - Zip Code:78382-3412
Mailing Address - Country:US
Mailing Address - Phone:361-790-9744
Mailing Address - Fax:
Practice Address - Street 1:GOLIAD HS
Practice Address - Street 2:749 TIGER DR
Practice Address - City:GOLIAD
Practice Address - State:TX
Practice Address - Zip Code:77963
Practice Address - Country:US
Practice Address - Phone:316-645-2833
Practice Address - Fax:361-645-2322
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT03872255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer