Escudero, Gary A

Escudero, Gary A is an individual health care provider with primary practice located at 516 E. Nizhoni Blvd Box 1337, Gallup NM 87301-1337. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Escudero, Gary A can be contacted via phone (505) 722-1000.

Contact Information

Primary practice address
516 E. Nizhoni Blvd Box 1337 Gallup NM 87301-1337
Phone: (505) 722-1000
Fax: (505) 722-1397
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 84-176 New Mexico

Profile Details

NPI number 1205867603
LBN Legal business name Escudero, Gary A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2006
Last updated Apr 11th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205867603 NPPES
New Mexico MEDICAID 000R6724
New Mexico MEDICAID 414582

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