Individual
DR. GORDON A. WITWER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12554 RIATA VISTA CIRCLE, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Mailing address
12554 RIATA VISTA CIRCLE, AUSTIN, TX 78727-6431
(512) 795-5100
(512) 795-5122
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
J5064
TX
2085R0202X
Diagnostic Radiology Physician
Primary
J5064
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134740305
—
TX
05
—
134740314
—
TX
Enumeration date
06/07/2006
Last updated
05/02/2016
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