Provider Demographics
NPI:1801882907
Name:GAGE, JOEL TODD (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:TODD
Last Name:GAGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5301 RIATA PARK CT
Mailing Address - Street 2:BLDG D SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-3437
Mailing Address - Country:US
Mailing Address - Phone:512-617-6000
Mailing Address - Fax:512-615-0459
Practice Address - Street 1:7215 WYOMING SPRINGS DR
Practice Address - Street 2:BLDG 1 SUITE 100
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4312
Practice Address - Country:US
Practice Address - Phone:512-617-6000
Practice Address - Fax:512-615-9908
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK5298207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143190002Medicaid
TXP00050190OtherMEDICARE RAILROAD
TX143190004Medicaid
TX143190002Medicaid
TX8K3830Medicare PIN
H36462Medicare UPIN
TX8L14541Medicare PIN
TX8A4051Medicare PIN