Provider Demographics
NPI:1831148170
Name:GMITTER, RICHARD CHRIS (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:CHRIS
Last Name:GMITTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W 34TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1205
Mailing Address - Country:US
Mailing Address - Phone:512-452-8533
Mailing Address - Fax:
Practice Address - Street 1:1201 W 38TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1006
Practice Address - Country:US
Practice Address - Phone:512-324-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8552207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139293819Medicaid
TX84722YOtherBCBS
TX139293811Medicaid
TX139293816OtherCIDC
TX8K9557OtherBCBS
TX139293803Medicaid
TX139293816OtherCSHCN
TX83042FOtherBCBS OF TX
TX139293809OtherCSHCN
TX139293810Medicaid
TX139293816OtherCSHCN
TXG13028Medicare UPIN
TX139293810Medicaid
TX84722YOtherBCBS
TX85X819Medicare PIN
TX8K9557OtherBCBS
TX139293816OtherCIDC
TX8B7167Medicare PIN
TX930061597Medicare PIN