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General NPI Number Information
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NPI Number | 1235791005
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Entity Type | Individual
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Provider Name | MITCHELL RONALD GAUGER MD
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Gender | Male
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Dates
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Enumeration Date | 07/02/2019
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 7004 BEE CAVES RD STE 2-100
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-5086
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Country | US
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Telephone | 512-642-5050
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Fax | 512-642-8186
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Provider Business Mailing Address
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Address Line | 7004 BEE CAVES RD STE 2-100
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City | WEST LAKE HILLS
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State | TX
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Zip | 78746-5086
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Country | US
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Telephone | 512-642-5050
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Fax | 512-642-8186
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 4351045673
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | V8262
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License Number State | TX
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