Provider Demographics
NPI:1154828259
Name:GOTLIB, DANIEL (DO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:GOTLIB
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1411 N BECKLEY AVE STE 152
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-1586
Mailing Address - Country:US
Mailing Address - Phone:214-948-7700
Mailing Address - Fax:214-948-7701
Practice Address - Street 1:1411 N BECKLEY AVE STE 152
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1586
Practice Address - Country:US
Practice Address - Phone:214-948-7700
Practice Address - Fax:214-948-7701
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2023-07-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXU2857207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine