Provider Demographics
NPI:1508836396
Name:GORE, DAVID CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:CHRISTOPHER
Last Name:GORE
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 1:5813 PRESTON RD
Mailing Address - Street 2:BLDG 554 - STE 207
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7354
Mailing Address - Country:US
Mailing Address - Phone:469-583-0820
Mailing Address - Fax:
Practice Address - Street 1:5813 PRESTON RD
Practice Address - Street 2:BLDG 554 - STE 207
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7354
Practice Address - Country:US
Practice Address - Phone:469-583-0820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6469207VM0101X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX041722208Medicaid
TX041722209Medicaid
TX041722212Medicaid
TX041722211Medicaid
TX041722202Medicaid
TX041722210Medicaid
TX041722204Medicaid
TX041722205Medicaid
TX041722206Medicaid
G00253Medicare UPIN
TX041722212Medicaid
TX041722202Medicaid