Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | K2156 | TX |
Y | 208600000X | Surgeon | K2156 | TX |
N | 2086X0206X | Surgical Oncologist | K2156 | TX |
NPI | 1083672836 |
---|---|
Provider Name | Dr. Brian Matthew Gogel |
First Address | Dallas, TX 75391-1230 |
Second Address | Dallas, TX 75230-2571 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 26/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
030086502 | (05) | TX |
030086503 | (05) | TX |
030086504 | (05) | TX |
H11327 | (02) | TX |
P01170816 | RAILROAD MEDICARE (01) | TX |