Provider Demographics
NPI:1851339105
Name:GULCHIN ERGUN, MD, PA
Entity Type:Organization
Organization Name:GULCHIN ERGUN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GULCHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ERGUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-526-5771
Mailing Address - Street 1:PO BOX 4346
Mailing Address - Street 2:DEPT 5400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4346
Mailing Address - Country:US
Mailing Address - Phone:713-526-5771
Mailing Address - Fax:713-526-2036
Practice Address - Street 1:6560 FANNIN STE 1160
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-526-5771
Practice Address - Fax:713-526-2036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172527701Medicaid
TX172527701Medicaid