Provider Demographics
NPI:1891843082
Name:GEVIN W WILLHELM, DO, PA
Entity Type:Organization
Organization Name:GEVIN W WILLHELM, DO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEVIN
Authorized Official - Middle Name:W
Authorized Official - Last Name:WILLHELM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:512-346-7661
Mailing Address - Street 1:8701 W PARMER LN
Mailing Address - Street 2:STE 1126
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-4942
Mailing Address - Country:US
Mailing Address - Phone:512-346-7661
Mailing Address - Fax:512-343-8041
Practice Address - Street 1:8701 W PARMER LN
Practice Address - Street 2:STE 1126
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-4942
Practice Address - Country:US
Practice Address - Phone:512-346-7661
Practice Address - Fax:512-343-8041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-06
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00531XMedicare PIN