Provider Demographics
NPI:1194707356
Name:SLOAN GORDON, DPM, PA
Entity type:Organization
Organization Name:SLOAN GORDON, DPM, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-988-6600
Mailing Address - Street 1:7500 BEECHNUT ST
Mailing Address - Street 2:#165
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-4335
Mailing Address - Country:US
Mailing Address - Phone:713-988-6600
Mailing Address - Fax:713-988-8850
Practice Address - Street 1:16651 SOUTHWEST FWY
Practice Address - Street 2:#230
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2345
Practice Address - Country:US
Practice Address - Phone:713-988-6600
Practice Address - Fax:713-988-8850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0803213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT13517Medicare UPIN
TX00174RMedicare ID - Type UnspecifiedFT BEND COUNTY