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Individual

DR. MICHAEL LAWRENCE GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
17215 RED OAK DR, SUITE 102, HOUSTON, TX 77090-2697
(281) 444-4114
(281) 444-7789
Mailing address
17215 RED OAK DR, SUITE 102, HOUSTON, TX 77090-2697
(281) 444-4114
(281) 444-7789

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
TX1487
TX
213ES0103X
Foot & Ankle Surgery Podiatrist
1487
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
043773302
TX
01
4344700001
PALMETTO GBA
TX
01
480033891
RAILROAD MEDICARE
TX
Enumeration date
06/29/2006
Last updated
12/11/2008
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