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General NPI Number Information
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NPI Number | 1487933347
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Entity Type | Organization
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Legal Business Name | GUADALUPANA FAMILY MEDICINE
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Dates
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Enumeration Date | 08/10/2011
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 903 S MAIN ST STE B107
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City | DUNCANVILLE
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State | TX
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Zip | 75137-2347
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Country | US
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Telephone | 972-772-9873
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Fax | 972-773-9854
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Provider Business Mailing Address
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Address Line | 903 S MAIN ST STE B107
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City | DUNCANVILLE
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State | TX
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Zip | 75137-2347
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Country | US
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Telephone | 972-772-9873
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Fax | 972-773-9854
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. BIBIANA LADINO
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Credential | MD
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Telephone | 972-773-9873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | N3806
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License Number State | TX
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