Healthcare Provider Details

I. General information

NPI: 1831148170
Provider Name (Legal Business Name): RICHARD CHRIS GMITTER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 09/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W 38TH ST
AUSTIN TX
78705-1006
US

IV. Provider business mailing address

720 W 34TH ST SUITE 101
AUSTIN TX
78705-1205
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-1010
  • Fax:
Mailing address:
  • Phone: 512-452-8533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberJ8552
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: