Provider Demographics
NPI:1962419325
Name:WHITMIRE, GERALD ALLEN (MD)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:ALLEN
Last Name:WHITMIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HICKORY SHADOWS DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-6750
Mailing Address - Country:US
Mailing Address - Phone:713-827-1655
Mailing Address - Fax:713-827-0120
Practice Address - Street 1:7515 MAIN ST
Practice Address - Street 2:SUITE 590 B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4519
Practice Address - Country:US
Practice Address - Phone:713-796-2595
Practice Address - Fax:713-796-0134
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0284207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00FL15Medicare ID - Type Unspecified
TXE35652Medicare UPIN