Individual provider · NPI-1

Eddie Gamboa

Technician/Technologist · El Paso, TX

NPI number1740010263
StatusActive
Last updated in NPPESAug 7, 2024

Details

NPI
1740010263
Entity type
Individual (NPI-1)
Name
Mr. Eddie Gamboa
Sex
Male
Sole proprietor
No
Enumeration date
Aug 7, 2024
Certification date
Aug 7, 2024
Last updated
Aug 7, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
156F00000X Technician/Technologist––Yes

Practice location

5001 N Piedras St
El Paso, TX 79930-4210

Phone 915-564-6100

Mailing address

5001 N Piedras St
El Paso, TX 79930-4210

Phone 915-564-6100

Other practice locations

350 Revere St
El Paso, TX 79905-1633

Phone 915-564-6100

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