MEDICARE: DR. VICTORINO GAFFUD CUMAGUN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	E4828	TX

General Provider Information

NPI Number	:	1164431250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTORINO GAFFUD CUMAGUN MD

Provider Business Mailing Address
First Line	:	3030 LA QUINTA DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-3130
Country	:	US
Telephone Number	:	281-438-5812
Fax Number	:

Provider Business Practice Location Address
First Line	:	3372 TAMPA ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-1144
Country	:	US
Telephone Number	:	713-622-0641
Fax Number	:	713-622-0649

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	02/19/2008

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