Provider Demographics
NPI:1558670935
Name:I L GOLD, MD, PA
Entity Type:Organization
Organization Name:I L GOLD, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:FELAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-299-0091
Mailing Address - Street 1:7777 SOUTHWEST FWY
Mailing Address - Street 2:1052
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074
Mailing Address - Country:US
Mailing Address - Phone:713-988-8776
Mailing Address - Fax:713-988-8662
Practice Address - Street 1:7777 SOUTHWEST FWY
Practice Address - Street 2:1052
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1802
Practice Address - Country:US
Practice Address - Phone:713-988-8776
Practice Address - Fax:713-988-8662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-01
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218382401Medicaid
TX0022WDOtherBCBS
TX219484701Medicaid
TXTXB110178Medicare PIN
TX0022WDOtherBCBS