Provider Demographics
NPI:1235119322
Name:ARISHITA, GARY I (MD)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:I
Last Name:ARISHITA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 29130
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229
Mailing Address - Country:US
Mailing Address - Phone:210-692-1181
Mailing Address - Fax:210-692-7584
Practice Address - Street 1:9635 HUEBNER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240
Practice Address - Country:US
Practice Address - Phone:210-692-1181
Practice Address - Fax:210-692-7584
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM85052086S0122X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery