| Doctor Name: | DR. GORMAN RILEY |
| NPI Number: | 1710297403 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | C5222 |
| Business Practice Address: | 201 Barclay Ave Apt 6 Wharton, TX - 774882861 |
| Business Phone Number: | 9792829875 |
| Business Fax Number: | |
| Mailing Address: | 201 Barclay Ave Apt 6, WHARTON |
| State: | TX |
| Postal Code: | 774882861 |
| Phone Number: | 9792829875 |
| Fax Number: | |
| NPI Enumeration Date: | 10/14/2010 |
| NPI Last Update Date: | 10/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | C5222 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |