Individual
JASON GUKHOOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2530 GULF FWY S, LEAGUE CITY, TX 77573-6743
(281) 337-7500
Mailing address
PO BOX 301157, DALLAS, TX 75303-1157
(877) 639-7611
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M4126
TX
207R00000X
Internal Medicine Physician
M4126
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176124902
—
TX
05
—
176124903
—
TX
01
—
1861509473
TRICARE SOUTH
TX
01
—
8S9234
BCBSTX PROV NO
TX
Enumeration date
08/23/2006
Last updated
03/08/2019
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