MEDICARE: IRVING L GOLD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	G1662	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	390004961	OTHER		RAILROAD GBA
5	0081BF	OTHER		BCBS#
6	8BF370	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1184659260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRVING L GOLD MD

Provider Business Mailing Address
First Line	:	7777 SOUTHWEST FREEWAY
Second Line	:	SUITE 1052
City	:	HOUSTON
State	:	TX
Zip	:	77074
Country	:	US
Telephone Number	:	713-988-8776
Fax Number	:	713-988-8662

Provider Business Practice Location Address
First Line	:	7777 SOUTHWEST FREEWAY
Second Line	:	SUITE 1052
City	:	HOUSTON
State	:	TX
Zip	:	77074
Country	:	US
Telephone Number	:	713-988-8776
Fax Number	:	713-988-8662

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	08/20/2018

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