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General NPI Number Information
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NPI Number | 1427386234
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Entity Type | Organization
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Legal Business Name | GARY S GOSSEN, M.D., P.A.
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Dates
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Enumeration Date | 12/07/2009
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Last Update Date | 01/19/2010
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Provider Practice Location Address
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Address Line | 4499 MEDICAL DR STE 126
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3735
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Country | US
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Telephone | 210-692-0088
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Fax | 210-692-0030
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Provider Business Mailing Address
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Address Line | 4499 MEDICAL DR STE 126
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3735
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Country | US
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Telephone | 210-692-0088
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Fax | 210-692-0030
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | NANCY M RICE
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Credential | R.N.
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Telephone | 210-692-0088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | F4014
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License Number State | TX
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