MEDICARE: ALFREDO F GURMENDI MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	L2294	TX

General Provider Information

NPI Number	:	1316272560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALFREDO F GURMENDI MD PA

Provider Business Mailing Address
First Line	:	205 W BOUTZ RD
Second Line	:	BLDG 1
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3262
Country	:	US
Telephone Number	:	575-532-7000
Fax Number	:	575-532-7006

Provider Business Practice Location Address
First Line	:	1200 RICHMOND AVE
Second Line	:	STE 330
City	:	HOUSTON
State	:	TX
Zip	:	77006-5424
Country	:	US
Telephone Number	:	713-334-0530
Fax Number	:	713-334-0552

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALFREDO F GURMENDI
Credential	:	MD
Telephone Number	:	713-334-0530

Provider Enumeration Date	:	10/06/2009
Last Update Date	:	10/06/2009

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