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General NPI Number Information
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NPI Number | 1205885837
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Entity Type | Organization
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Legal Business Name | LUIS GAITAN, MD., PA.
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 4770 N EXPRESSWAY SUITE 100
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City | BROWNSVILLE
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State | TX
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Zip | 78526-4120
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Country | US
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Telephone | 956-550-9020
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Fax | 956-550-9050
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Provider Business Mailing Address
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Address Line | PO BOX 676786
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City | DALLAS
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State | TX
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Zip | 75267-6786
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Country | US
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Telephone | 956-550-9020
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Fax | 956-550-9050
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LUIS E GAITAN
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Credential | M.D.
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Telephone | 956-550-9020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | K1442
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License Number State | TX
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