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1871527036
GUSTAVO LICEA
EDINBURG, TX
NPI
1871527036
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207L00000X Anesthesiology
(Licence: TX J2657)
Enumeration Date
2006-07-11
Last Update Date
2007-07-08
Business Address
Dr. GUSTAVO LICEA M.D.
3513 W ALBERTA RD
EDINBURG, TX 78539-8466
Phone number: 956-664-9771
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Mailing Address
Dr. GUSTAVO LICEA M.D.
PO BOX 720550
MCALLEN, TX 78504-0550
Phone number: 956-664-9771
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