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NPI Code Detail

MEDICARE: OSVALDO GAYTAN JR. M.D.

MEDICARE: OSVALDO GAYTAN JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry PhysicianM5181TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346220043
Entity Type Code : Individual
Provider Name (Legal Business Name) : OSVALDO GAYTAN JR. M.D.
Provider Business Mailing Address
First Line : 1605 GEORGE DIETER DR
Second Line : STE 636
City : EL PASO
State : TX
Zip : 79936-5692
Country : US
Telephone Number : 915-671-1371
Fax Number : 915-219-9022
Provider Business Practice Location Address
First Line : 1900 DENVER AVE.
Second Line :
City : EL PASO
State : TX
Zip : 79902-3008
Country : US
Telephone Number : 915-544-4000
Fax Number : 915-532-0733
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2006
Last Update Date : 08/08/2025

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