MEDICARE: ECONO SALUD PLLC

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1750772026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECONO SALUD PLLC

Provider Business Mailing Address
First Line	:	7202 TURTLE LAGOON ROW
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-4416
Country	:	US
Telephone Number	:	832-525-5032
Fax Number	:

Provider Business Practice Location Address
First Line	:	7202 TURTLE LAGOON ROW
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-4416
Country	:	US
Telephone Number	:	832-525-5032
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STAN LEE GORE
Credential	:
Telephone Number	:	832-525-5032

Provider Enumeration Date	:	02/09/2015
Last Update Date	:	02/09/2015

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Directions to “ECONO SALUD PLLC ” Practice Location

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