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General NPI Number Information
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NPI Number | 1780617282
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Entity Type | Individual
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Provider Name | GAUTAM R MOORJANI MD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 19272 STONE OAK PARKWAY SUITE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78258
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Country | US
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Telephone | 210-265-8851
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Fax | 210-265-8855
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Provider Business Mailing Address
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Address Line | 19272 STONE OAK PARKWAY SUITE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78258
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Country | US
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Telephone | 210-265-8851
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Fax | 210-265-8855
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 20040814
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | N0997
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License Number State | TX
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