Provider Demographics
NPI:1316194533
Name:SWALDEK, GNIEWOMIRA P (MD)
Entity Type:Individual
Prefix:
First Name:GNIEWOMIRA
Middle Name:P
Last Name:SWALDEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4515 SETON CENTER PKWY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5290
Mailing Address - Country:US
Mailing Address - Phone:512-407-8686
Mailing Address - Fax:512-421-4489
Practice Address - Street 1:6001 KYLE PKWY
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6112
Practice Address - Country:US
Practice Address - Phone:512-504-5000
Practice Address - Fax:512-324-1984
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP01549207R00000X
PAMD441371207R00000X
TXP4719207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX337568502Medicaid
TX337568501Medicaid
TX337568502Medicaid
TX355798YLP1Medicare PIN