Gumbo, Tawanda
Gumbo, Tawanda is an individual health care provider with primary practice located at Ut Southwestern Medical Ctr 5323 Harry Hines Blvd, Dallas TX 75390-9113. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Gumbo, Tawanda can be contacted via phone (214) 648-9914.Contact Information
Primary practice address
Ut Southwestern Medical Ctr 5323 Harry Hines Blvd
Dallas TX 75390-9113
Phone: (214) 648-9914
Fax: (214) 648-2741
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 002080 | New York |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 41626 | Texas |
Profile Details
| NPI number | 1255323317 |
|---|---|
| LBN Legal business name | Gumbo, Tawanda |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 16th, 2005 |
| Last updated | Jul 8th, 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 | 1255323317 | NPPES |
| New York | MEDICAID | 02353648 |
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