Organization Active NPI

Daniel M Gold MD PA

  • Eyewear Supplier
  • Crockett, TX
National Provider Identifier
1083745848
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
DANIEL M GOLD MD PA
Practice address
407 Gossett Ave
Crockett, TX 75835-1507
Phone
(936) 545-2020
Fax
(903) 545-9352
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Authorized official

Name
Daniel M Gold, MD
Title
Owner
Phone
(903) 723-3250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X TX Primary

Addresses

Primary practice location

407 Gossett Ave
Crockett, TX 75835-1507

Mailing address

501 E Kolstad St
Palestine, TX 75801-2352
Phone (903) 723-3250

Other identifiers 1

IdentifierTypeStateIssuer
085168502MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Palestine Eye Clinic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1501 E Loop 304
Crockett, TX 75835

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661990400000",
    "number": "1083745848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E KOLSTAD ST",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758012352",
            "telephone_number": "903-723-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 GOSSETT AVE",
            "city": "CROCKETT",
            "state": "TX",
            "postal_code": "758351507",
            "telephone_number": "936-545-2020",
            "fax_number": "903-545-9352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL M GOLD MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A",
        "authorized_official_last_name": "GOLD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-723-3250",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085168502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crockett, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.