Provider Demographics
NPI:1003037243
Name:ROBERT C GOHLKE DDS INC
Entity type:Organization
Organization Name:ROBERT C GOHLKE DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:NEAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-861-3231
Mailing Address - Street 1:1445 NORTH LOOP WEST
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008
Mailing Address - Country:US
Mailing Address - Phone:713-861-3231
Mailing Address - Fax:713-426-1720
Practice Address - Street 1:1445 NORTH LOOP WEST
Practice Address - Street 2:SUITE 1000
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008
Practice Address - Country:US
Practice Address - Phone:713-681-5117
Practice Address - Fax:713-426-1720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty