Provider Demographics
NPI:1396125654
Name:GAIDARSKI, ALEXANDER A III (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:A
Last Name:GAIDARSKI
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALEXANDER
Other - Middle Name:
Other - Last Name:GAIDARSKI
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:214-234-0813
Practice Address - Street 1:3144 HORIZON RD STE 110
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-7046
Practice Address - Country:US
Practice Address - Phone:972-771-3322
Practice Address - Fax:972-771-0272
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN19732390200000X
TXT7218208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program