Organization Name: | UVALDE DIAGNOSTIC CLINIC |
NPI Number: | 1104948645 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GAJANAN V GAITONDE (PRESIDENT) |
Mailing Address: | 101 Jolley St Uvalde |
State: | TX US |
Postal Code: | 788014815 |
Phone Number: | 8302784568 |
Fax Number: | |
NPI Enumeration Date: | 04/04/2007 |
NPI Last Update Date: | 10/29/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G1011 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |