Provider Demographics
NPI:1710090329
Name:GOKAL, HASAN KASSIM (MD)
Entity Type:Individual
Prefix:
First Name:HASAN
Middle Name:KASSIM
Last Name:GOKAL
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 1:7103 TIEDMANN PARK WAY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4494
Mailing Address - Country:US
Mailing Address - Phone:281-725-3229
Mailing Address - Fax:
Practice Address - Street 1:7103 TIEDMANN PARK WAY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4494
Practice Address - Country:US
Practice Address - Phone:281-725-3229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217633-1207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02214551Medicaid
NYH40302Medicare UPIN