Provider Demographics
NPI:1225118573
Name:GOSS, JOHN A (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:GOSS
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 1:6620 MAIN ST STE 1450
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2346
Mailing Address - Country:US
Mailing Address - Phone:713-798-8100
Mailing Address - Fax:713-798-4530
Practice Address - Street 1:6620 MAIN ST STE 1450
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2346
Practice Address - Country:US
Practice Address - Phone:713-798-8100
Practice Address - Fax:713-798-4530
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2023-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5969208600000X, 2086S0120X, 204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX116597901Medicaid
TX116597903Medicaid
020049095OtherRR MEDICARE
TX116597904OtherCSHCN
LA1672009Medicaid
86715FMedicare PIN
TX116597904OtherCSHCN
G09583Medicare UPIN