Individual
DR. JOEL GERARD GOTVALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
208600000X
Surgery Physician
K4694
TX
2086S0129X
Vascular Surgery Physician
Primary
K4694
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
272053137
—
TX
05
—
99680262
—
CO
01
—
P00365013
RAILROAD MEDICARE
—
Enumeration date
03/20/2006
Last updated
07/09/2025
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