Provider Demographics
NPI:1275803041
Name:EWE GHEE GOH M.D.
Entity Type:Organization
Organization Name:EWE GHEE GOH M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:EWE
Authorized Official - Middle Name:GHEE
Authorized Official - Last Name:GOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-943-4331
Mailing Address - Street 1:302 W 9TH ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-4809
Mailing Address - Country:US
Mailing Address - Phone:214-943-4331
Mailing Address - Fax:
Practice Address - Street 1:302 W 9TH ST
Practice Address - Street 2:SUITE G
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4809
Practice Address - Country:US
Practice Address - Phone:214-943-4331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4842208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092158701Medicaid
TX092158702Medicaid
TX1609910579OtherNPI
TX092158702Medicaid