MEDICARE: MANOJ K GOGIA MD

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	207R00000X	Internal Medicine Physician	J9055	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	:	1841280518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANOJ K GOGIA MD

Provider Business Mailing Address
First Line	:	3414 OAKMONT DR
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550-7832
Country	:	US
Telephone Number	:	956-412-6946
Fax Number	:	956-412-6946

Provider Business Practice Location Address
First Line	:	2106 TREASURE HILLS BLVD
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550-8736
Country	:	US
Telephone Number	:	956-366-4500
Fax Number	:	956-366-4501

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	07/08/2010

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