Provider Demographics
NPI:1124091079
Name:GOSSEN, GARY SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:SCOTT
Last Name:GOSSEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8550 DATAPOINT DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3270
Mailing Address - Country:US
Mailing Address - Phone:210-615-8308
Mailing Address - Fax:210-615-8313
Practice Address - Street 1:8550 DATAPOINT DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3270
Practice Address - Country:US
Practice Address - Phone:210-615-8308
Practice Address - Fax:210-615-8313
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2015-10-15
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Provider Licenses
StateLicense IDTaxonomies
TXF4014207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF4014OtherSTATE LICENSE NUMBER
TX8F23303Medicare PIN
TXB23087Medicare UPIN