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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255323317 NPPES
New York MEDICAID 02353648

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