Provider Demographics
NPI:1750673224
Name:NEIL L. GORME, M.D., D.D.S., INC.
Entity Type:Organization
Organization Name:NEIL L. GORME, M.D., D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:L
Authorized Official - Last Name:GORME
Authorized Official - Suffix:
Authorized Official - Credentials:MD,DDS
Authorized Official - Phone:713-795-4120
Mailing Address - Street 1:6560 FANNIN ST
Mailing Address - Street 2:1600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2761
Mailing Address - Country:US
Mailing Address - Phone:713-795-4120
Mailing Address - Fax:713-795-4123
Practice Address - Street 1:6560 FANNIN ST
Practice Address - Street 2:1600
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2761
Practice Address - Country:US
Practice Address - Phone:713-795-4120
Practice Address - Fax:713-795-4123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty