Espes Est,llc
Psychiatry & Neurology, Neurology in Gallup, NM. Organization (NPI-2).
NPI number1528359148
StatusActive
Last updated in NPPESOct 28, 2011
Details
- NPI
- 1528359148
- Entity type
- Organization (NPI-2)
- Legal business name
- Espes Est,llc
- Organization subpart
- No
- Enumeration date
- Apr 29, 2011
- Last updated
- Oct 28, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology, Neurology | 97-23 | NM | Yes |
| 207RI0200X | Internal Medicine, Infectious Disease | 97-60 | NM | |
| 2084N0600X | 97-23 | NM | ||
| 2084S0012X | Psychiatry & Neurology, Sleep Medicine | 97-23 | NM |
Other names
- Gallup Neurology (Doing Business As)
Practice location
1211 E Aztec AveGallup, NM 87301-4901
Phone 505-870-9647
Mailing address
1070 Rancho RdGallup, NM 87301-7036
Phone 505-870-9647
Authorized official
Flor Jarasa Caballar Gonzaga
Organizer/Member
5058709647
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