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General NPI Number Information
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NPI Number | 1578205787
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Entity Type | Organization
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Legal Business Name | GENTIANA BAKAJ MD PLLC
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Dates
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Enumeration Date | 04/08/2022
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Last Update Date | 04/21/2022
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Provider Practice Location Address
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Address Line | 1902 JOHN STOCKBAUER DR SUITE 300 & 400
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City | VICTORIA
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State | TX
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Zip | 77901-3797
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Country | US
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Telephone | 361-894-6094
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Fax | 361-576-4219
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Provider Business Mailing Address
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Address Line | 1902 JOHN STOCKBAUER DR SUITE 300 & 400
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City | VICTORIA
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State | TX
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Zip | 77901-3797
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Country | US
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Telephone | 361-894-6094
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Fax | 361-576-4219
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Authorized Official
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Title or Position | OWNER
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Name | GENTIANA BAKAJ
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Credential | MD
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Telephone | 361-894-6094
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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 |
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License Number State |
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