Provider Demographics
NPI:1053518605
Name:GOGIA, PREM P (DPT, PHD)
Entity type:Individual
Prefix:DR
First Name:PREM
Middle Name:P
Last Name:GOGIA
Suffix:
Gender:M
Credentials:DPT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2938
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77487-2938
Mailing Address - Country:US
Mailing Address - Phone:281-566-1121
Mailing Address - Fax:281-566-1153
Practice Address - Street 1:13017 JESS PIRTLE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:281-566-1121
Practice Address - Fax:281-566-1153
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1042711225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86897TOtherBCBS