| Requeijo-gamboa Epc Aco Llc | |
|
1001 Mountain St Carson City NV 89703-3848 | |
| (737) 226-6700 | |
| Not Available |
| Full Name | Requeijo-gamboa Epc Aco Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1001 Mountain St, Carson City, Nevada |
| Authorized Official Name and Position | Antonio Gamboa (OWNER) |
| Authorized Official Contact | 7372266700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Requeijo-gamboa Epc Aco Llc 3901a Spicewood Springs Rd Ste 201 Austin TX 78759-8728 Ph: (737) 226-6700 | Requeijo-gamboa Epc Aco Llc 1001 Mountain St Carson City NV 89703-3848 Ph: (737) 226-6700 |
| NPI Number | 1700460938 |
|---|---|
| Provider Enumeration Date | 05/12/2021 |
| Last Update Date | 05/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700460938 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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