Dr Leo Dan Gordon, DDS is a
Dentist - General Practice based in Weimar, Texas. Dr Leo Dan Gordon is licensed to practice in Texas (license number TX15621) and his current practice location is
503 E Main St, Weimar, Texas. He can be reached at his office (for appointments etc.) via phone at
(979) 725-8562.
NPI number for Dr Leo Dan Gordon is 1073593497 and his current mailing address is 503 E Main St, Weimar, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1073593497.
Healthcare Provider's Profile
| Full Name | Dr Leo Dan Gordon |
|---|
| Gender | Male |
|---|
| Speciality | Dentist - General Practice |
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| Location | 503 E Main St, Weimar, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1073593497
- Provider Enumeration Date: 01/20/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Leo Dan Gordon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073593497 | NPI | - | NPPES |
| D15621 | Other | | BCBS |
| 837109 | Other | | UNITED CONCORDIA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | TX15621 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Leo Dan Gordon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Leo Dan Gordon, DDS
503 E Main St,
Weimar, TX 78962
Ph: (979) 725-8562 | Dr Leo Dan Gordon, DDS
503 E Main St,
Weimar, TX 78962
Ph: (979) 725-8562 |
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