MEDICARE: GILBERT C. PRICE DDS

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	122300000X	Dentist	12380	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093186678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GILBERT C. PRICE DDS

Provider Business Mailing Address
First Line	:	24141 HIGHWAY 59 STE E
Second Line	:
City	:	PORTER
State	:	TX
Zip	:	77365-6141
Country	:	US
Telephone Number	:	281-354-4241
Fax Number	:	281-354-9379

Provider Business Practice Location Address
First Line	:	24141 HIGHWAY 59 STE E
Second Line	:
City	:	PORTER
State	:	TX
Zip	:	77365-6141
Country	:	US
Telephone Number	:	281-354-4241
Fax Number	:	281-354-9379

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. GILBERT COLEMAN PRICE
Credential	:	DDS
Telephone Number	:	281-354-4241

Provider Enumeration Date	:	10/08/2015
Last Update Date	:	10/08/2015

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