Provider Demographics
NPI:1194716001
Name:ARREDONDO, ADAM GALLARDO (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:GALLARDO
Last Name:ARREDONDO
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 1:128 N HIGHWAY 77
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-1800
Mailing Address - Country:US
Mailing Address - Phone:972-938-7319
Mailing Address - Fax:972-923-9535
Practice Address - Street 1:128 N HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-1800
Practice Address - Country:US
Practice Address - Phone:972-938-7319
Practice Address - Fax:972-923-9535
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7648174400000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1429474-01Medicaid
TX8Z0632OtherBCBS PROVIDER NUMBER
TX7035048OtherAETNA PROVIDER NUMBER
TX1429474-01Medicaid