Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | E9652 | TX |
NPI | 1043211816 |
---|---|
Provider Name | Dr. Bienvenido Gatmaitan Gatmaitan |
First Address | Arlington, TX 76015-2535 |
Second Address | Arlington, TX 76015-2535 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C16026 | (02) |