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NPI Code Detail

MEDICARE: MR. GIL A SOBREMONTE CMD

MEDICARE: MR. GIL A SOBREMONTE CMD
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
12471R0002XRadiation Therapy Radiologic Technologist

General Provider Information

NPI Number : 1679678692
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GIL A SOBREMONTE CMD
Provider Business Mailing Address
First Line : 907 WHITBY CT
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-5919
Country : US
Telephone Number : 713-794-1414
Fax Number :
Provider Business Practice Location Address
First Line : 2002 HOLCOMBE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77030-4211
Country : US
Telephone Number : 713-791-1414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2006
Last Update Date : 07/08/2007

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