Provider Demographics
NPI:1497746812
Name:ERGUN, GULCHIN A (MD)
Entity Type:Individual
Prefix:
First Name:GULCHIN
Middle Name:A
Last Name:ERGUN
Suffix:
Gender:F
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:PO BOX 4346
Mailing Address - Street 2:DEPT 540
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4346
Mailing Address - Country:US
Mailing Address - Phone:713-933-2650
Mailing Address - Fax:713-933-2653
Practice Address - Street 1:6560 FANNIN ST STE 1160
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2725
Practice Address - Country:US
Practice Address - Phone:713-933-2650
Practice Address - Fax:713-933-2653
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4886207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100529003Medicaid
TX100529003Medicaid
TX8E0311Medicare PIN