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Organization
THE VAZ CLINIC
Active
Organization
THE VAZ CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARTH OLSTEIN VAZ M.D. (PRESIDENT)
(830) 672-2424
Entity
Organization
Contact information
Practice address
1103 N SARAH DEWITT DR, GONZALES, TX 78629-3311
(830) 672-2424
(866) 622-2180
Mailing address
1103 N SARAH DEWITT DR, GONZALES, TX 78629-3311
(830) 672-2424
(866) 622-2180
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
J3644
TX
207Q00000X
Family Medicine Physician
Primary
J3644
TX
261QC1800X
Corporate Health Clinic/Center
J3644
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203310201
MEDICAID
TX
Enumeration date
04/14/2009
Last updated
07/20/2016
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