MEDICARE: MR. OBED GAYTAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	34714	TX

General Provider Information

NPI Number	:	1902699978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. OBED GAYTAN

Provider Business Mailing Address
First Line	:	2980 CREEK BEND DR APT 6107
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-6485
Country	:	US
Telephone Number	:	830-708-9400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2980 CREEK BEND DR APT 6107
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-6485
Country	:	US
Telephone Number	:	830-708-9400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2025
Last Update Date	:	05/23/2025

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Directions to “ MR. OBED GAYTAN ” Practice Location

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