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General NPI Number Information
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NPI Number | 1417195231
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Entity Type | Organization
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Legal Business Name | JANA K NUNEZ-GUSSMAN MD PA
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 02/02/2009
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Provider Practice Location Address
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Address Line | 2929 CALDER ST STE 312
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City | BEAUMONT
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State | TX
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Zip | 77702-1831
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Country | US
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Telephone | 409-835-1333
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Fax | 409-835-2629
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Provider Business Mailing Address
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Address Line | 2929 CALDER ST STE 312
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City | BEAUMONT
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State | TX
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Zip | 77702-1831
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Country | US
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Telephone | 409-835-1333
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Fax | 409-835-2629
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Authorized Official
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Title or Position | OWNER
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Name | DR. JANA K NUNEZ-GUSSMAN
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Credential | MD
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Telephone | 409-835-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | L7504
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License Number State | TX
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