EL PASO INFECTIOUS DISEASES, PA
Osteopathic Medicine at Medical Center Dr, El Paso, TX

License number
Texas M8004
Category
Osteopathic Medicine
Type
Infectious Disease
Owner
Name: JACQUELYN ANN GOUVEIA D.O.
Title: PHYSICIAN - OWNER
Phone: (915) 400-2600
Address
Address
1626 Medical Center Dr, El Paso, TX 79902
National Provider ID: 1437571114
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EL PASO INFECTIOUS DISEASES, PA

El Paso, TX

Status:
Inactive
Industry:
Medical Doctor's Office
Doing business as:
El Paso Infectious Diseases, PA
Registration:
Mar 31, 2011
Addresses:
PO Box 220357, El Paso, TX 79913 (Mailing)
10701 Sam Snead Dr, El Paso, TX 79935
State ID:
0801405679
Business type:
Professional Association
Director, Member, President, Secretary, Vice-President:
Jacquelyn A. Gouveia Director, Member, President, Secretary, Vice-President, inactive
TIN:
32043936510

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