Provider Demographics
NPI:1174556286
Name:GOCKE, KARNA (MD)
Entity type:Individual
Prefix:
First Name:KARNA
Middle Name:
Last Name:GOCKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 W. UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078
Mailing Address - Country:US
Mailing Address - Phone:469-329-7860
Mailing Address - Fax:972-347-6224
Practice Address - Street 1:1970 W. UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078
Practice Address - Country:US
Practice Address - Phone:469-329-7860
Practice Address - Fax:972-347-6224
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69631207Q00000X
TXQ9359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB249733Medicare PIN
TX564421YKP5Medicare PIN