Gustavo C Licea Mdpa

NPI 1033459581 - Anesthesiology - 207L00000X

NPI Details
NPI 1033459581
Enumeration Date 02/20/2013
Last Updated 02/20/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name GUSTAVO C GUSTAVO
Position OWNER
Phone (956) 664-9771
Fax (956) 664-9773
Practice Location
2010 S CYNTHIA ST
STE 101
MCALLEN TX, 78503-1386, US
Phone (956) 664-9771
Fax (956) 664-9773
Business Location
PO BOX 720162
MCALLEN TX, 78504-0162, US
Phone (956) 664-9771
Fax (956) 664-9773
Toxanomy
Taxonomy Code 207L00000X
License State
License Number
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According to our database, Gustavo C Licea Mdpa NPI is 1033459581, taxonomy code is 207L00000X Gustavo C Licea Mdpa physically located at 2010 S Cynthia St, Mcallen TX, 78503-1386. NPI Number 1033115704 has the healthcare provider type.

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1033459581 NPI number is provided on an as is basis without warranty of any kind. 1033459581 is maintained by the National Plan & Provider Enumeration System. The contents of Gustavo C Licea Mdpa are for informational purposes only.