Provider Demographics
NPI:1841280518
Name:GOGIA, MANOJ K (MD)
Entity type:Individual
Prefix:
First Name:MANOJ
Middle Name:K
Last Name:GOGIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3414 OAKMONT DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7832
Mailing Address - Country:US
Mailing Address - Phone:956-412-6946
Mailing Address - Fax:956-412-6946
Practice Address - Street 1:2106 TREASURE HILLS BLVD
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8736
Practice Address - Country:US
Practice Address - Phone:956-366-4500
Practice Address - Fax:956-366-4501
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ9055207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133629908Medicaid
TX8B6468Medicare ID - Type Unspecified
TX133629908Medicaid