Jack Charles Gordon, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

E7606 Issued in TX

Practice address

1604 Hospital Pkwy
Suite 207
Bedford, TX 76022-6986

Phone

(817) 283-4452

Fax

(817) 685-0897

NPI assigned

May 1, 2006

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1437116597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 HOSPITAL PKWY",
            "address_2": "SUITE 207",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760226986",
            "telephone_number": "817-283-4452",
            "fax_number": "817-685-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 HOSPITAL PKWY",
            "address_2": "SUITE 207",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760226986",
            "telephone_number": "817-283-4452",
            "fax_number": "817-685-0897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "JACK",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "E7606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Gnanaprakasam
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• Abigail Justine Goode
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• Charles Kenneth Gordon, D.O.
• Sibonginkosi Goremucheche
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• Peter Edward Grays, M.D.
• Green Oaks Physical Therapy Limited Partnership (Green Oaks Physical Therapy)

• Specialist in Bedford, TX
• Providers in Bedford, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.