Individual
DR. KEVIN W. DWYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1507 W MAIN ST, GATESVILLE, TX 76528-1024
(254) 865-8251
Mailing address
1507 W MAIN ST, GATESVILLE, TX 76528-1024
(254) 865-8251
(254) 248-6306
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
J1980
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1358483-05
—
TX
01
—
1358483-09
CSHCN
TX
01
—
300115478
RR/MEDICARE
TX
01
—
84198K
BLUE SHIELD
TX
Enumeration date
03/24/2006
Last updated
07/31/2023
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