Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 275586 | NY |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | P5276 | TX |
Y | 207YS0123X | Facial Plastic Surgeon | P5276 | TX |
NPI | 1497915540 |
---|---|
Provider Name | Dr. Eli A Gordin |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 19/09/2018 |