Gustavo J Medellin Md Pa

NPI 1467578971 - Hospitalist - 208M00000X

NPI Details
NPI 1467578971
Enumeration Date 03/22/2007
Last Updated 03/25/2015
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name GUSTAVO JAVIER GUSTAVO
Position PRESIDENT
Phone (210) 558-6288
Fax (210) 558-6289
Practice Location
4085 DE ZAVALA RD
SUITE 200
SHAVANO PARK TX, 78249-2084, US
Phone (210) 558-6288
Fax (210) 558-6289
Business Location
PO BOX 1158
SAN ANTONIO TX, 78294-1158, US
Phone (210) 558-6288
Fax (210) 558-6289
Toxanomy
Taxonomy Code 208M00000X
License State Texas
License Number K0129
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According to our database, Gustavo J Medellin Md Pa NPI is 1467578971, taxonomy code is 208M00000X and license number is K0129, license state is located at Texas. Gustavo J Medellin Md Pa physically located at 4085 De Zavala Rd, Shavano Park TX, 78249-2084. NPI Number 1033115704 has the healthcare provider type.

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1467578971 NPI number is provided on an as is basis without warranty of any kind. 1467578971 is maintained by the National Plan & Provider Enumeration System. The contents of Gustavo J Medellin Md Pa are for informational purposes only.