MEDICARE: GOUXIANG HE 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	207Q00000X	Family Medicine Physician	K3749	TX

General Provider Information

NPI Number	:	1073536835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GOUXIANG HE M.D.

Provider Business Mailing Address
First Line	:	7048 BISSONNET ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77074-6010
Country	:	US
Telephone Number	:	713-644-3602
Fax Number	:	713-643-3405

Provider Business Practice Location Address
First Line	:	4040 BROADWAY ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77087-4704
Country	:	US
Telephone Number	:	713-644-3602
Fax Number	:	713-643-3405

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	07/08/2007

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Directions to “ GOUXIANG HE M.D.” Practice Location

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