GUSTAVO C LICEA MDPA

MCALLEN, TX
NPI1033459581
Entity TypeOrganization
Authorized ContactGUSTAVO C LICEA
Owner
956-664-9771
Organization Subpart ?No
Primary Taxonomy207L00000X Anesthesiology
Enumeration Date2013-02-20
Last Update Date2013-02-20
Business Address
GUSTAVO C LICEA MDPA
2010 S CYNTHIA ST STE 101
MCALLEN, TX 78503-1386
Phone number: 956-664-9771
Mailing Address
GUSTAVO C LICEA MDPA
PO BOX 720162
MCALLEN, TX 78504-0162
Phone number: 956-664-9771
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