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General NPI Number Information
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NPI Number | 1316347396
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Entity Type | Individual
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Provider Name | DR. NESTOR GAYTAN
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Gender | Male
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Dates
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Enumeration Date | 08/27/2014
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 1780 N LEE TREVINO DR
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City | EL PASO
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State | TX
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Zip | 79936-4522
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Country | US
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Telephone | 915-799-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 MICHELANGELO DR
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City | EL PASO
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State | TX
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Zip | 79936-7245
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Country | US
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Telephone | 915-740-4993
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 55353
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License Number State | TX
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