Individual
JOSE L. ULLOA-GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4800 ALBERTA AVE, EL PASO, TX 79905-2709
(915) 545-8823
(915) 545-7374
Mailing address
PO BOX 9520, EL PASO, TX 79995-9520
(915) 545-6664
(915) 545-9799
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
41996 TEMPORARY LIC.
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41996
TEMPORARY LICENSE
TX
Enumeration date
01/07/2008
Last updated
01/07/2008
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