Padron, Gustavo M
Padron, Gustavo M is an individual health care provider with primary practice located at 2555 Jimmy Johnson Blvd , Port Arthur TX 77643. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Padron, Gustavo M can be contacted via phone (409) 853-5863.Contact Information
Primary practice address
2555 Jimmy Johnson Blvd
Port Arthur TX 77643
Phone: (409) 853-5863
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | J1751 | Texas |
Profile Details
| NPI number | 1417911090 |
|---|---|
| LBN Legal business name | Padron, Gustavo M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 12th, 2006 |
| Last updated | May 8th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417911090 | NPPES |
| Texas | MEDICAID | 124167102 |
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