| J. Chris Gorham Pa | |
|
2000 S I H 35 Ste K1 Round Rock TX 78681-6916 | |
| (512) 255-7839 | |
| (512) 255-7898 |
| Full Name | J. Chris Gorham Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2000 S I H 35 Ste K1, Round Rock, Texas |
| Authorized Official Name and Position | J. Chris Gorham (OWNER) |
| Authorized Official Contact | 5122557839 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Chris Gorham Pa 2000 S I H 35 Ste K1 Round Rock TX 78681-6916 Ph: (512) 255-7839 | J. Chris Gorham Pa 2000 S I H 35 Ste K1 Round Rock TX 78681-6916 Ph: (512) 255-7839 |
| NPI Number | 1700930708 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 02/01/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700930708 | NPI | - | NPPES |
| 89D255 | Other | TX | BLUE CROSS BLUE SHIELD OF TEXAS |
| 89D254 | Other | TX | BLUE CROSS BLUE SHIELD OF TEXAS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 20097 (Texas) | Primary |
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