Provider Demographics
NPI:1073536835
Name:HE, GOUXIANG (MD)
Entity Type:Individual
Prefix:
First Name:GOUXIANG
Middle Name:
Last Name:HE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7048 BISSONNET ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-6010
Mailing Address - Country:US
Mailing Address - Phone:713-644-3602
Mailing Address - Fax:713-643-3405
Practice Address - Street 1:4040 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-4704
Practice Address - Country:US
Practice Address - Phone:713-644-3602
Practice Address - Fax:713-643-3405
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK3749207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG62924Medicare UPIN