Organization
GARY S GOSSEN, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY M RICE R.N. (OFFICE MANAGER)
(210) 692-0088
Entity
Organization
Contact information
Practice address
4499 MEDICAL DR, STE 126, SAN ANTONIO, TX 78229-3735
(210) 692-0088
(210) 692-0030
Mailing address
4499 MEDICAL DR, STE 126, SAN ANTONIO, TX 78229-3735
(210) 692-0088
(210) 692-0030
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
F4014
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A5483
MEDICARE PTAN
TX
01
—
1124091079
NPI TYPE 1
TX
01
—
F4014
LICENSE NUMBER
TX
Enumeration date
12/07/2009
Last updated
01/19/2010
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