MEDICARE: DR. PHILIP LAIRD GOULD M.D., MPH

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	19994	NE
2	2083P0901X	Public Health & General Preventive Medicine Physician	19994	NE

General Provider Information

NPI Number	:	1558326884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP LAIRD GOULD M.D., MPH

Provider Business Mailing Address
First Line	:	2513 KENNEDY CIR
Second Line	:
City	:	BROOKS CITY-BASE
State	:	TX
Zip	:	78235-5116
Country	:	US
Telephone Number	:	210-536-5497
Fax Number	:

Provider Business Practice Location Address
First Line	:	2513 KENNEDY CIR
Second Line	:
City	:	BROOKS CITY-BASE
State	:	TX
Zip	:	78235-5116
Country	:	US
Telephone Number	:	210-536-5497
Fax Number	:

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	09/11/2025

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