Provider Demographics
NPI:1720241136
Name:GOR, TROY (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:
Last Name:GOR
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 GRAMERCY ST APT 2103
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3119
Mailing Address - Country:US
Mailing Address - Phone:903-738-4503
Mailing Address - Fax:
Practice Address - Street 1:1720 YALE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-4032
Practice Address - Country:US
Practice Address - Phone:713-802-0449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX229271223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics