BRENT GORDON (NPI# 1376512152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376512152 |
| Entity Type | Individual |
| Full Name | BRENT GORDON |
| Credential | DO |
| Practice Address |
3629 Western Center Blvd Ste. 211 Fort Worth TX 76137-1939 |
| Practice Telephone | 8172329115 |
| Practice Fax Number | 8172329130 |
| Mailing Telephone | 8172329115 |
| Mailing Fax Number | 8172329130 |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2015-04-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | H7558 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 131610106 | 05 | |
| TX | RAILROAD MEDICARE | P00281271 | 01 |
| TX | BCBS | 8J9054 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417318577 | Brent M Gordon | Counselor | 5505 S Pacific Hwy, Phoenix, OR 97535 | 2016-03-16 |
| 1710391040 | Brent Kobe Gordon | Emergency Medicine | 2315 Stockton Blvd, Sacramento, CA 95817 | 2014-06-14 |
| 1669480083 | Brent Mcnairy Gordon | Internal Medicine | 11234 Anderson St, Rm 4433, Loma Linda, CA 92354-2804 | 2006-08-03 |
| Street Address |
3629 WESTERN CENTER BLVD STE. 211 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76137-1939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427415314 | Prestige Dermatology of Alliance, Pllc | Family Medicine | 3629 Western Center Blvd, Suite 201, Fort Worth, TX 76137-1939 | 2016-01-22 |
| 1144649088 | Ketki Manohar Rana | Physical Therapist | 3629 Western Center Blvd, Ste.221, Fort Worth, TX 76137-1939 | 2014-04-08 |
| 1336420918 | Christina Catherine Jones | Counselor | 3629 Western Center Blvd, Fort Worth, TX 76137-1939 | 2011-09-08 |
| 1215164835 | Jason M Mccoy | Social Worker | 3629 Western Center Blvd, Ste. 211, Fort Worth, TX 76137-1939 | 2009-06-22 |
| 1710133897 | Craig Freyer, M.d. | General Practice | 3629 Western Center Blvd, Suite 201, Fort Worth, TX 76137-1939 | 2008-08-08 |
| 1720097801 | Craig Alan Freyer | Family Medicine | 3629 Western Center Blvd, 201, Fort Worth, TX 76137-1939 | 2006-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962975581 | Rose Kabera | Registered Nurse | 8021 Jolie Dr, Fort Worth, TX 76137 | 2019-01-07 |
| 1043786569 | Grace-marie Jones | Licensed Vocational Nurse | 5201 Endicott Avenue, Fort Worth, TX 76137 | 2018-10-23 |
| 1104327683 | Jeris Taylor | Registered Nurse | 4144 Heritage Way Dr, Fort Worth, TX 76137 | 2018-02-21 |
| 1396269429 | Matthew Pedroza | Dentist | 4625 Feathercrest Dr., Fort Worth, TX 76137 | 2017-07-31 |
| 1447789896 | Texas Surgical Ally | Physician Assistant | 6677 Friendsway Dr, Fort Worth, TX 76137 | 2017-06-08 |
| 1992249239 | Tracy Kirk Dds, Pllc | Dentist | 6300 N. Beach St, Ft Worth, TX 76137 | 2016-12-06 |
| 1992103295 | Keller Modern Dentistry and Orthodontics, PC | Dentist | 5701 N. Tarrant Pkwy, Suite 101, Fort Worth, TX 76137 | 2014-12-18 |
| 1619380805 | Ikids Pediatric Dentistry and Orthodontics Nfw | Dentist | 7451 N Beach St, Ste 140, Fort Worth, TX 76137 | 2014-06-05 |
| 1205246758 | Jack Milton Curlee Jr. | Counselor | 3629 Western Center Blvd., Suite 211, Fort Worth, TX 76137 | 2014-05-06 |
| 1932457363 | Milestone Dental of Keller, Pllc | Dentist | 5800 North Tarrant Parkway, Suite 102, Fort Worth, TX 76137 | 2012-08-15 |
| Find all providers in zip 76137 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184020 | Kara Fenceroy | Family Medicine | 5425 Rolling Meadows Dr, Fort Worth, TX 76123-2836 | 2020-11-03 |
| 1003416207 | Adeline Galvez | Family Medicine | 1300 W Terrell Ave Ste 270, Fort Worth, TX 76104-2820 | 2020-10-27 |
| 1952870354 | Nancy Carolina Nicoloso | Family Medicine | 6302 Lake Worth Blvd Ste A3963, Fort Worth, TX 76135-3607 | 2018-11-15 |
| 1245717586 | Julia Dubose | Family Medicine | 4100 Heritage Trace Pkwy Ste 116, Fort Worth, TX 76244 | 2018-07-19 |
| 1609307115 | Yara Hamade Gonzales | Family Medicine | 4701 Bryant Irvin Rd, Fort Worth, TX 76132-3603 | 2017-03-26 |
| 1558732321 | Andres Morgado Perez | Family Medicine | 1325 Pennsylvania Ave Ste 750, Fort Worth, TX 76104-2168 | 2015-10-19 |
| 1114304805 | Davis Wellness Ltd LLP | Family Medicine | 3750 S. University Dr., Suite 201, Fort Worth, TX 76109-3701 | 2015-05-01 |
| 1902298417 | Jack Lynwood Judson, Md | Family Medicine | 1800 Malibar Rd, Fort Worth, TX 76116-1834 | 2015-02-21 |
| 1104243468 | Henry Dollahite | Family Medicine | 6205 Locke Ave, Fort Worth, TX 76116-4636 | 2014-03-25 |
| 1447676689 | Janet Shackelford | Family Medicine | 5001 Golden Triangle Blvd, # 1024, Fort Worth, TX 76244 | 2014-03-12 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76137 |
Please comment or provide details below to improve the information on BRENT GORDON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.