Mark A Gordon, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01291 Issued in TX

Practice address

13601 Wood Forest Blvd
Houston, TX 77015

Phone

(713) 330-4325

Fax

(713) 330-1910

NPI assigned

Mar 27, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750409629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 ROLLING BROOK DR",
            "address_2": "#211",
            "city": "BAYTOWN",
            "state": "TX",
            "postal_code": "77521",
            "telephone_number": "817-506-0580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13601 WOOD FOREST BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77015",
            "telephone_number": "713-330-4325",
            "fax_number": "713-330-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Danielle Gordon
• Lawrence Gordon, D.C.
• Leilani Louise Gordon
• Lenee Lansford Gordon, FNP-C
• Lillian Gordon, REGISTERED NURSE
• Mary Gordon, PHD, RN
• Matthew C Gordon, L.A.T., A.T.C.
• Michael Lawrence Gordon, DPM
• Mollie Rebecca Gordon, M.D.
• Niarra Gordon

• Physician Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Physician Assistant 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.