Witwer, Gordon A.
Witwer, Gordon A. is an sole proprietor health care provider with primary practice located at 12554 Riata Vista Circle , Austin TX 78727-6431. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Witwer, Gordon A. can be contacted via phone (512) 795-5100.Contact Information
Primary practice address
12554 Riata Vista Circle
Austin TX 78727-6431
Phone: (512) 795-5100
Fax: (512) 795-5122
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | J5064 | Texas |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | J5064 | Texas |
Profile Details
| NPI number | 1053351932 |
|---|---|
| LBN Legal business name | Witwer, Gordon A. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 7th, 2006 |
| Last updated | May 2nd, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053351932 | NPPES |
| Texas | MEDICAID | 134740305 | |
| Texas | MEDICAID | 134740314 |
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