Fuentes, Michael Gerard

Fuentes, Michael Gerard is an sole proprietor health care provider with primary practice located at 5656 S Staples St Ste 252, Corpus Christi TX 78411-4655. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Fuentes, Michael Gerard can be contacted via phone (361) 888-7716.

Contact Information

Primary practice address
5656 S Staples St Ste 252 Corpus Christi TX 78411-4655
Fax: (361) 888-7718
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X K4062 Texas

Profile Details

NPI number 1689721383
LBN Legal business name Fuentes, Michael Gerard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 4th, 2007
Last updated Mar 5th, 2014 - about 11 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 1689721383 NPPES
Texas MEDICAID 030121001

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