Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | K1154 | TX |
NPI | 1003877432 |
---|---|
Provider Name | Dr. Gordon D Luk |
First Address | Dallas, TX 75247-4228 |
Second Address | Bedford, TX 76022-6000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 25/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104462002 | (05) | TX |
84Y115 | BCBSTX (01) | TN |
B45638 | (02) | TX |