Individual
DR. DIANE GOUGE BARTELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-0462
(409) 772-4194
Mailing address
1001 CASTLE RIDGE RD, AUSTIN, TX 78746-5109
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
BP1-0023106
TX
208000000X
Pediatrics Physician
Primary
MD60094958
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3803307301
MYUTMB 3803307301-COMMERCIAL NUMBER
—
Enumeration date
06/14/2007
Last updated
10/29/2020
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