Provider Demographics
NPI:1184284853
Name:ENENMOH, AUSTIN GOZIAM (MD)
Entity type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:GOZIAM
Last Name:ENENMOH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7909 FREDERICKSBURG RD STE 110
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3400
Mailing Address - Country:US
Mailing Address - Phone:106-144-5442
Mailing Address - Fax:210-679-3724
Practice Address - Street 1:7909 FREDERICKSBURG RD STE 125
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3448
Practice Address - Country:US
Practice Address - Phone:210-614-4544
Practice Address - Fax:210-679-3712
Is Sole Proprietor?:No
Enumeration Date:2019-06-16
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXV0388208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology