Individual provider Active NPI

Gordon L Klein, MD

  • Pediatric Gastroenterology Physician
  • Galveston, TX
National Provider Identifier
1780765479
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
H1793 Issued in TX
Practice address
301 University Blvd
RT 1022
Galveston, TX 77555-5302
Phone
(409) 772-2222
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X H1793 TX Primary

Addresses

Primary practice location

301 University Blvd
RT 1022
Galveston, TX 77555-5302

Mailing address

301 University Blvd
RT 1022
Galveston, TX 77555-5302
Phone (409) 772-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110107000370 TX Practitioner - Pediatric MedicinePractitioner - Orthopedic Surgery 2466591706 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TP857KYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice CurrentSince Sep 1, 1998 Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

301 University Blvd
#1022
Galveston, TX 77555
Phone (409) 772-0848

Organizations & group practices 1

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780765479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "address_2": "RT 1022",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "address_2": "RT 1022",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555302",
            "telephone_number": "409-772-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "GORDON",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TX",
            "license": "H1793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

Verify at the official NPI Registry.