| Organization Name: | JOSEPH M. GARDZINA |
| NPI Number: | 1336523356 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH GARDZINA (CEO) |
| Mailing Address: | 1111 W Adoue St Bldg 1 Alvin |
| State: | TX US |
| Postal Code: | 775112718 |
| Phone Number: | 8324573540 |
| Fax Number: | 2813775870 |
| NPI Enumeration Date: | 07/20/2015 |
| NPI Last Update Date: | 07/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | 3351-3642 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |