Individual
ANTONIO GAMBOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7000 NORTH MOPAC, #180, AUSTIN, TX 78731
(512) 482-0045
(512) 476-9892
Mailing address
7000 NORTH MOPAC, # 180, AUSTIN, TX 78731
(512) 482-0045
(512) 476-9892
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
33649
AZ
207R00000X
Internal Medicine Physician
Primary
M7983
TX
208000000X
Pediatrics Physician
33649
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202793004
—
TX
05
—
202793005
—
TX
05
—
202793006
—
TX
05
—
202793007
—
TX
05
—
946999
—
AZ
Enumeration date
07/12/2006
Last updated
08/14/2014
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