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General NPI Number Information
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NPI Number | 1861714628
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Entity Type | Organization
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Legal Business Name | GOBER LLC
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Dates
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Enumeration Date | 02/22/2010
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 108 N HOUSTON ST
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City | EDGEWOOD
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State | TX
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Zip | 75117-2500
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Country | US
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Telephone | 903-896-1700
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Fax | 903-896-1701
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Provider Business Mailing Address
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Address Line | PO BOX 234
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City | EDGEWOOD
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State | TX
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Zip | 75117-2500
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Country | US
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Telephone | 903-896-1700
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Fax | 903-896-1701
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN GOBER
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Credential |
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Telephone | 903-896-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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