Healthcare Provider Details

I. General information

NPI: 1699092304
Provider Name (Legal Business Name): BILLY SHU GAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10905 MEMORIAL HERMANN DR STE 111
PEARLAND TX
77584-3490
US

IV. Provider business mailing address

10905 MEMORIAL HERMANN DR STE 111
PEARLAND TX
77584-3490
US

V. Phone/Fax

Practice location:
  • Phone: 281-929-4727
  • Fax:
Mailing address:
  • Phone: 281-929-4727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberU7423
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number1044134
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: