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Individual

MICHAEL M GNUECHTEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
310 WESLEY DR, KERRVILLE, TX 78028-5822
(830) 895-4443
(830) 257-2077
Mailing address
PO BOX 293355, KERRVILLE, TX 78029-3355
(830) 895-4443
(830) 257-2077

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
H8081
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
096908102
TX
01
742906311
TAX ID
TX
Enumeration date
08/17/2005
Last updated
03/28/2011
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