Provider Demographics
NPI:1649356346
Name:GADOL, STEVEN M (MD PA)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:M
Last Name:GADOL
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:399 W CAMPBELL RD
Mailing Address - Street 2:# 202
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3606
Mailing Address - Country:US
Mailing Address - Phone:972-498-4401
Mailing Address - Fax:972-498-4407
Practice Address - Street 1:399 W CAMPBELL RD
Practice Address - Street 2:# 202
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3606
Practice Address - Country:US
Practice Address - Phone:972-498-4401
Practice Address - Fax:972-498-4407
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ2945207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115828903Medicaid
TX115828903Medicaid
F67932Medicare UPIN