Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | R6178 | TX |
NPI | 1013303916 |
---|---|
Provider Name | Guadalupe Duran |
First Address | Laredo, TX 78045-9016 |
Second Address | Laredo, TX 78041-5474 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 10/10/2018 |