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General NPI Number Information
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NPI Number | 1528314721
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Entity Type | Individual
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Provider Name | LOUI CHAN GATDULA MD
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Gender | Male
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 06/17/2016
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Provider Practice Location Address
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Address Line | 2101 W LOOP 281
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City | LONGVIEW
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State | TX
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Zip | 75604-2506
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Country | US
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Telephone | 903-315-5600
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Fax | 903-315-2757
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Provider Business Mailing Address
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Address Line | PO BOX 4207
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City | LONGVIEW
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State | TX
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Zip | 75606-4207
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Country | US
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Telephone | 903-315-4105
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Fax | 903-315-4130
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BP10044198
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | Q3516
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License Number State | TX
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