MEDICARE: GULCHIN A ERGUN M.D.

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	207RG0100X	Gastroenterology Physician	K4886	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

General Provider Information

NPI Number	:	1497746812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GULCHIN A ERGUN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 4346
Second Line	:	DEPT 540
City	:	HOUSTON
State	:	TX
Zip	:	77210-4346
Country	:	US
Telephone Number	:	713-933-2650
Fax Number	:	713-933-2653

Provider Business Practice Location Address
First Line	:	6560 FANNIN ST STE 1160
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2725
Country	:	US
Telephone Number	:	713-933-2650
Fax Number	:	713-933-2653

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

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	09/14/2011

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