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General NPI Number Information
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NPI Number | 1811974264
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Entity Type | Organization
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Legal Business Name | GIL TEIXEIRA DO INC
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 400 MASSASOIT AVE STE 300
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-2012
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Country | US
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Telephone | 401-434-2704
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Fax | 401-383-6521
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Provider Business Mailing Address
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Address Line | 400 MASSASOIT AVE STE300
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-2012
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Country | US
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Telephone | 401-434-2704
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Fax | 401-383-6521
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Authorized Official
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Title or Position | OWNER
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Name | GILBERT TEIXEIRA
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Credential | DO
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Telephone | 401-434-2704
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | DO00545
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License Number State | RI
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