Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2013-01783 | NC |
N | 111NI0900X | Internist | 2013-01783 | NC |
N | 207R00000X | Internist | Q6197 | TX |
N | 111NI0900X | Internist | Q6197 | TX |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | Q6197 | TX |
N | 207RC0000X | Internist - Cardiovascular Disease | 2013-01783 | NC |
N | 207RC0000X | Internist - Cardiovascular Disease | Q6197 | TX |
NPI | 1386855922 |
---|---|
Provider Name | Dr. Robert Lawrence Gottlieb |
First Address | Dallas, TX 75246-2003 |
Second Address | Dallas, TX 75246-2003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2007 |
Last Update Date | 20/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3539785-01 | (05) | TX |
3539785-02 | (05) | TX |