Dr. Gordon Kim Rainey, MD
Dermatology in San Antonio, TX. Individual provider (NPI-1).
NPI number1528046331
StatusActive
Last updated in NPPESJul 23, 2020
Details
- NPI
- 1528046331
- Entity type
- Individual (NPI-1)
- Name
- Dr. Gordon Kim Rainey
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 3, 2006
- Certification date
- Jul 23, 2020
- Last updated
- Jul 23, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | 22511 | NE | Yes |
| 208D00000X | General Practice | 22511 | NE |
Practice location
3551 Roger Brooke Dr#607
San Antonio, TX 78234-4504
Phone 210-292-5350 · Fax 210-292-3781
Mailing address
3551 Roger Brooke DrFort Sam Houston, TX 78234-4504
Phone 210-916-4581
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