Gamut Medical Group Pa | |
8524 Mountain Ash Dr El Paso TX 79904-2442 | |
(915) 783-8162 | |
(915) 351-6601 |
Full Name | Gamut Medical Group Pa |
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Speciality | Family Medicine |
Location | 8524 Mountain Ash Dr, El Paso, Texas |
Authorized Official Name and Position | Ulysses Urquidi (PRESIDENT) |
Authorized Official Contact | 9157838162 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Gamut Medical Group Pa 8524 Mountain Ash Dr El Paso TX 79904-2442 Ph: (915) 783-8162 | Gamut Medical Group Pa 8524 Mountain Ash Dr El Paso TX 79904-2442 Ph: (915) 783-8162 |
NPI Number | 1790083012 |
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Provider Enumeration Date | 03/10/2011 |
Last Update Date | 03/10/2011 |
Medicare PECOS PAC ID | 4385821685 |
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Medicare Enrollment ID | O20110615000060 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790083012 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | L4774 (Texas) | Primary |
Provider Name | Ulysses Urquidi |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245288109 PECOS PAC ID: 7012938087 Enrollment ID: I20051219000303 |
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