Individual
MR. GUSTAVO HERRERA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
10880 EDGEMERE BLVD, EL PASO, TX 79935-1306
(915) 590-7800
Mailing address
10880 EDGEMERE BLVD, EL PASO, TX 79935-1306
(915) 590-7800
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2096289
TX
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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