Active NPI
Craig S Gordon, M.D.
- Specialist
- Katy, TX
National Provider Identifier
1821079013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- F4848
- Practice address
- 21316 Provincial Blvd
Katy, TX 77450-7580 - Phone
- (281) 647-6667
- Fax
- (281) 647-6610
- NPI assigned
- Nov 7, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | F4848 | TX | Primary |
Addresses
Primary practice location
21316 Provincial Blvd
Katy, TX 77450-7580
Mailing address
21316 Provincial Blvd
Katy, TX 77450-7580
Phone (281) 647-6667
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F4848 | TX | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571184000000",
"number": "1821079013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21316 PROVINCIAL BLVD",
"city": "KATY",
"state": "TX",
"postal_code": "774507580",
"telephone_number": "281-647-6667",
"fax_number": "281-647-6610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21316 PROVINCIAL BLVD",
"city": "KATY",
"state": "TX",
"postal_code": "774507580",
"telephone_number": "281-647-6667",
"fax_number": "281-647-6610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "CRAIG",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-07",
"last_updated": "2019-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "TX",
"license": "F4848",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.