Provider Demographics
NPI:1184659260
Name:GOLD, IRVING L (MD)
Entity Type:Individual
Prefix:
First Name:IRVING
Middle Name:L
Last Name:GOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 SOUTHWEST FREEWAY
Mailing Address - Street 2:SUITE 1052
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074
Mailing Address - Country:US
Mailing Address - Phone:713-988-8776
Mailing Address - Fax:713-988-8662
Practice Address - Street 1:7777 SOUTHWEST FREEWAY
Practice Address - Street 2:SUITE 1052
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074
Practice Address - Country:US
Practice Address - Phone:713-988-8776
Practice Address - Fax:713-988-8662
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1662207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113715006Medicaid
TX113715005Medicaid
TX113715002Medicaid
390004961OtherRAILROAD GBA
0081BFOtherBCBS#
TX8BF370OtherBCBS
TXTXB110179Medicare PIN
TX8BF370OtherBCBS
TX113715006Medicaid
TXTXB110171Medicare PIN