Individual
MR. JAMIE EDEN GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6121 HWY 161, SUITE 225, IRVING, TX 75038
(469) 528-1169
(877) 319-1790
Mailing address
8528 DAVIS BLVD STE 134, NORTH RICHLAND HILLS, TX 76182-8302
(469) 528-1169
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
01059066A
IN
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
K9790
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000567134
ANTHEM BCBS
IN
Enumeration date
11/16/2005
Last updated
10/03/2022
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