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General NPI Number Information
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NPI Number | 1891339644
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Entity Type | Organization
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Legal Business Name | ATTIGO INFUSION INC
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Dates
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Enumeration Date | 11/05/2019
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 15301 SPECTRUM DR STE 330
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City | ADDISON
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State | TX
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Zip | 75001-6462
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Country | US
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Telephone | 972-661-2273
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Fax | 972-421-1899
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Provider Business Mailing Address
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Address Line | 15301 SPECTRUM DR STE 330
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City | ADDISON
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State | TX
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Zip | 75001-6462
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Country | US
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Telephone | 972-661-2273
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Fax | 972-421-1899
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Authorized Official
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Title or Position | CEO
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Name | GUSTAVO DE AVILLEZ
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Credential |
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Telephone | 972-661-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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