Provider Demographics
NPI:1467754614
Name:GULFTON HEALTHCARE, INC.
Entity Type:Organization
Organization Name:GULFTON HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-492-0054
Mailing Address - Street 1:6065 HILLCROFT ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-1087
Mailing Address - Country:US
Mailing Address - Phone:713-492-0054
Mailing Address - Fax:
Practice Address - Street 1:6065 HILLCROFT ST
Practice Address - Street 2:SUITE 306
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-1087
Practice Address - Country:US
Practice Address - Phone:713-492-0054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-20
Last Update Date:2010-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty