Individual
DR. JOEL GERARD GOTVALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2217 PARK BEND DR, STE 230 FL2, AUSTIN, TX 78758-5674
(512) 220-5401
(512) 220-5440
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
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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