Michael Scott Gorback, M.D.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

J7502 Issued in TX

Practice address

17099 Texas Ave
300
Webster, TX 77598-4069

Phone

(281) 554-3400

Fax

(281) 554-3404

NPI assigned

Jul 19, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730188087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17099 TEXAS AVE",
            "address_2": "300",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984069",
            "telephone_number": "281-554-3400",
            "fax_number": "281-554-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17099 TEXAS AVE",
            "address_2": "300",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984069",
            "telephone_number": "281-554-3400",
            "fax_number": "281-554-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORBACK",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "J7502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Pain Medicine Physician in Webster, TX
• Providers in Webster, TX by specialty
• Interventional Pain Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.