Provider Demographics
NPI:1811227374
Name:DEEN, GORDON H I (MD)
Entity Type:Individual
Prefix:DR
First Name:GORDON
Middle Name:H
Last Name:DEEN
Suffix:I
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 1:46 CLUB ESTATES PKWY
Mailing Address - Street 2:
Mailing Address - City:THE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78738-1429
Mailing Address - Country:US
Mailing Address - Phone:512-261-1413
Mailing Address - Fax:512-261-8931
Practice Address - Street 1:46 CLUB ESTATES PKWY
Practice Address - Street 2:
Practice Address - City:THE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78738-1429
Practice Address - Country:US
Practice Address - Phone:512-261-1413
Practice Address - Fax:512-261-8931
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3584208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty