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General NPI Number Information
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NPI Number | 1376953224
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Entity Type | Individual
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Provider Name | MARK GOLD M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 501 E KOLSTAD ST
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City | PALESTINE
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State | TX
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Zip | 75801-2352
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Country | US
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Telephone | 903-723-3250
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Fax | 903-723-5550
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Provider Business Mailing Address
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Address Line | 501 E KOLSTAD ST
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City | PALESTINE
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State | TX
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Zip | 75801-2352
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Country | US
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Telephone | 903-723-3250
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Fax | 903-723-5550
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BP20054342
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | R5399
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License Number State | TX
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