Individual provider Active NPI

Prem P Gogia, DPT, PHD

  • Physical Therapist
  • Sugar Land, TX
National Provider Identifier
1053518605
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1042711 Issued in TX
Practice address
13017 Jess Pirtle Blvd Ste 100
Sugar Land, TX 77478
Phone
(281) 566-1121
Fax
(281) 566-1153
NPI assigned
Jun 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1042711 TX Primary

Addresses

Primary practice location

13017 Jess Pirtle Blvd Ste 100
Sugar Land, TX 77478

Mailing address

PO Box 2938
Sugar Land, TX 77487-2938
Phone (281) 566-1121

Other identifiers 1

IdentifierTypeStateIssuer
86897TOtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Acura Hospice Care LLC Current Accepting new patients
Legend Rehab Center LLC Physical Therapist PastSince Jan 1, 2001 Accepting new patients
Epic Ambulance, LLC Past Accepting new patients

Locations

13017 Jess Pirtle Blvd
Ste 100
Sugar Land, TX 77478
Phone (281) 566-1121

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1053518605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2938",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774872938",
            "telephone_number": "281-566-1121",
            "fax_number": "281-566-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13017 JESS PIRTLE BLVD STE 100",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "77478",
            "telephone_number": "281-566-1121",
            "fax_number": "281-566-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOGIA",
        "first_name": "PREM",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DPT, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-28",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1042711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86897T",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.