Provider Demographics
NPI:1316154073
Name:T. GOPAL & ASSOCIATES, M.D., P.A.
Entity type:Organization
Organization Name:T. GOPAL & ASSOCIATES, M.D., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THANDAVARAJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOPALAKRISHNAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-484-3500
Mailing Address - Street 1:10594 FUQUA ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-1402
Mailing Address - Country:US
Mailing Address - Phone:281-484-3500
Mailing Address - Fax:281-484-3517
Practice Address - Street 1:10594 FUQUA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-1402
Practice Address - Country:US
Practice Address - Phone:281-484-3500
Practice Address - Fax:281-484-3517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5966207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00506UOtherGROUP MC #T GOPAL & ASSOC
TXI04507OtherMC UPIN DR. BALASUBRAMANI
TX8A1987Medicare ID - Type UnspecifiedDR. GOPAL INDIVIDUAL
TX00506UOtherGROUP MC #T GOPAL & ASSOC
TXG37467 DR. GOPAL'SMedicare UPIN
TXI04507OtherMC UPIN DR. BALASUBRAMANI
TX8A1986Medicare ID - Type UnspecifiedDR. S INDIVIDUAL