Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 12358 | TX |
Y | 213EG0000X | General Practice | 12358 | TX |
NPI | 1003031782 |
---|---|
Provider Name | Dr. Stephen Charles Gould |
First Address | Houston, TX 77018-8127 |
Second Address | Houston, TX 77018-8127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 08/07/2007 |