Teofilo S. Bautista, M.d., P.c

NPI 1215110200 - Clinic/Center - 261QP2300X

NPI Details
NPI 1215110200
Enumeration Date 12/12/2007
Last Updated 12/12/2007
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name TEOFILO TEOFILO
Position PRESIDENT
Phone (219) 938-4481
Fax (219) 938-6480
Practice Location
642 S LAKE ST
GARY IN, 46403-2967, US
Phone (219) 938-4481
Fax (219) 938-6480
Business Location
642 S LAKE ST
GARY IN, 46403-2967, US
Phone (219) 938-4481
Fax (219) 938-6480
Toxanomy
Taxonomy Code 261QP2300X
License State Indiana
License Number 01032450A
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According to our database, Teofilo S. Bautista, M.d., P.c NPI is 1215110200, taxonomy code is 261QP2300X and license number is 01032450A, license state is located at Indiana. Teofilo S. Bautista, M.d., P.c physically located at 642 S Lake St, Gary IN, 46403-2967. NPI Number 1033115704 has the healthcare provider type.

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1215110200 NPI number is provided on an as is basis without warranty of any kind. 1215110200 is maintained by the National Plan & Provider Enumeration System. The contents of Teofilo S. Bautista, M.d., P.c are for informational purposes only.