Healthcare Provider Details

I. General information

NPI: 1346241361
Provider Name (Legal Business Name): ALFREDO F. GURMENDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 08/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 JOE RAMSEY BLVD E STE 100
GREENVILLE TX
75401
US

IV. Provider business mailing address

4351 E. LOHMAN AVENUE SUITE 200
LAS CRUCES NM
88011
US

V. Phone/Fax

Practice location:
  • Phone: 903-408-7730
  • Fax: 903-408-7739
Mailing address:
  • Phone: 575-556-1581
  • Fax: 575-556-1583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberL2294
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: