Gavino Dermatology, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

GAVINO DERMATOLOGY, PLLC

Practice address

9073 W State Highway 29 Ste 108
Liberty Hill, TX 78642-2396

Phone

(737) 377-3143

Fax

(737) 200-8237

NPI assigned

Jun 28, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Alde Carlo Patdu Gavino, MDNPI 1255534863

Title

MD/Owner

Phone

(737) 377-3143

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00137

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alde Carlo Patdu Gavino, M.D.

  • Dermatopathology Physician
  • Liberty Hill, TX
  • NPI 1255534863

  Dermatology

  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1619609682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9073 W STATE HIGHWAY 29 STE 108",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786422396",
            "telephone_number": "737-377-3143",
            "fax_number": "737-200-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9073 W STATE HIGHWAY 29 STE 108",
            "city": "LIBERTY HILL",
            "state": "TX",
            "postal_code": "786422396",
            "telephone_number": "737-377-3143",
            "fax_number": "737-200-8237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3502 Wild Cherry Dr Bldg 1",
            "address_purpose": "LOCATION",
            "city": "Lakeway",
            "state": "TX",
            "postal_code": "787381826",
            "country_code": "US",
            "telephone_number": "737-377-3143",
            "fax_number": "737-200-8237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GAVINO DERMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-28",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "GAVINO",
        "authorized_official_first_name": "ALDE CARLO",
        "authorized_official_middle_name": "PATDU",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "737-377-3143",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Christina Ford, R.D.
• Danielle Fortune-Jack, LPC-A
• Kendra Friemel
• Ram Mohanbhai Gadhia, MD
• Carissa Garza
• Alde Carlo Patdu Gavino, M.D.
• Sheri Gaynor, RN
• Tiffany Georgiefski, D.D.S
• Kerstin Holl Gillespie, DNP, APRN, FNP-BC
• Thad Harold Gillespie, D.D.S.

• Dermatology Physician in Liberty Hill, TX
• Providers in Liberty Hill, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.