Provider Demographics
NPI:1689604852
Name:GURWITZ, BRAD W (MD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:W
Last Name:GURWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8122 DATAPOINT DR STE 320
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3264
Mailing Address - Country:US
Mailing Address - Phone:210-614-5113
Mailing Address - Fax:210-616-0024
Practice Address - Street 1:8122 DATAPOINT DR STE 320
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3264
Practice Address - Country:US
Practice Address - Phone:210-614-5113
Practice Address - Fax:210-616-0024
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ0831208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103616201Medicaid
TX103616201Medicaid
TX834857Medicare ID - Type Unspecified