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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053351932 NPPES
Texas MEDICAID 134740305
Texas MEDICAID 134740314

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