Bourgeois, Gary Michael
Bourgeois, Gary Michael is an sole proprietor health care provider with primary practice located at 1071 Country Club Rd Suite Q, El Paso TX 79932-3173. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Bourgeois, Gary Michael can be contacted via phone (915) 581-0171.Contact Information
Primary practice address
1071 Country Club Rd Suite Q
El Paso TX 79932-3173
Phone: (915) 581-0171
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 0018214 | Texas |
Profile Details
| NPI number | 1629260773 |
|---|---|
| LBN Legal business name | Bourgeois, Gary Michael |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 13th, 2007 |
| Last updated | Aug 13th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629260773 | NPPES |
| Texas | MEDICAID | 4789 |
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