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Individual

GARY MARTIN MAILMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4316 JAMES CASEY ST, SUITE B 100, AUSTIN, TX 78745-1116
(512) 306-1903
(512) 551-9295
Mailing address
PO BOX 4268, AUSTIN, TX 78765-4268
(512) 306-1903
(512) 551-9295

Taxonomy

Speciality
Code
Description
License number
State
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
Primary
J9186
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10015657
AMERIGROUP
TX
05
118009002
TX
01
87Y621
BCBS
TX
Enumeration date
09/22/2005
Last updated
04/28/2015
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