Active NPI
Tina Louise Gore, LMT
- Contractor
- Waxahachie, TX
National Provider Identifier
1275714925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- MT104092
- Practice address
- 1170 Colorado Dr
Waxahachie, TX 75167-8199 - Phone
- (972) 938-2316
- Fax
- (972) 937-8780
- NPI assigned
- Nov 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | MT104092 | TX | Primary |
Addresses
Primary practice location
1170 Colorado Dr
Waxahachie, TX 75167-8199
Mailing address
1170 Colorado Dr
Waxahachie, TX 75167-8199
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT104092 | TX | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195776000000",
"number": "1275714925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1170 COLORADO DR",
"city": "WAXAHACHIE",
"state": "TX",
"postal_code": "751678199",
"fax_number": "972-938-8780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1170 COLORADO DR",
"city": "WAXAHACHIE",
"state": "TX",
"postal_code": "751678199",
"telephone_number": "972-938-2316",
"fax_number": "972-937-8780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORE",
"first_name": "TINA",
"middle_name": "LOUISE",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-23",
"last_updated": "2007-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "TX",
"license": "MT104092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waxahachie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.