Healthcare Provider Details

I. General information

NPI: 1205007432
Provider Name (Legal Business Name): KATJA GWIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. KATJA SCHUERFELD

II. Dates (important events)

Enumeration Date: 03/15/2008
Last Update Date: 08/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 HARRY HINES BLVD DALLAS
DALLAS TX
75390-0001
US

IV. Provider business mailing address

UT SOUTHWESTERN MEDICAL CTR P.O. BOX 845347
DALLAS TX
75284-0001
US

V. Phone/Fax

Practice location:
  • Phone: 203-737-4142
  • Fax: 203-785-7146
Mailing address:
  • Phone: 214-645-4851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberP7278
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: