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NPI 1649356346

NPI 1649356346 : STEVEN M GADOL MD PA : RICHARDSON, TX

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General NPI Number Information
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    NPI Number           |    1649356346
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    Entity Type          |    Individual 
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    Provider Name        |    STEVEN M GADOL MD PA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/27/2006
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    Last Update Date     |    08/19/2010
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Provider Practice Location Address
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    Address Line         |    399 W CAMPBELL RD # 202
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    City                 |    RICHARDSON
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    State                |    TX
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    Zip                  |    75080-3606
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    Country              |    US
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    Telephone            |    972-498-4401
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    Fax                  |    972-498-4407
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Provider Business Mailing Address
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    Address Line         |    399 W CAMPBELL RD # 202
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    City                 |    RICHARDSON
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    State                |    TX
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    Zip                  |    75080-3606
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    Country              |    US
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    Telephone            |    972-498-4401
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    Fax                  |    972-498-4407
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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        |    207RG0100X
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    Taxonomy Name        |    Gastroenterology Physician
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    License Number       |    J2945
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    License Number State |    TX
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