Organization
UVALDE DIAGNOSTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAJANAN V GAITONDE MD (PRESIDENT)
(830) 278-4568
Entity
Organization
Contact information
Practice address
101 JOLLEY ST, UVALDE, TX 78801-4815
(830) 278-4568
Mailing address
101 JOLLEY ST, UVALDE, TX 78801-4815
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G1011
TX
208D00000X
General Practice Physician
G1011
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178042101
—
TX
Enumeration date
04/04/2007
Last updated
10/29/2012
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