Individual
MR. CHARLES D. GAUTHIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7400 MERTON MINTER BOULEVARD, SAN ANTONIO, TX 78284
(210) 699-2149
Mailing address
12507 POINT SMT, SAN ANTONIO, TX 78253-5270
(210) 679-9917
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 03873
TX
Other
Enumeration date
09/05/2006
Last updated
07/08/2007
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