Individual
DR. LUIS E GAITAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4770 N EXPRESSWAY, SUITE 100, BROWNSVILLE, TX 78526-4120
(956) 550-9020
(956) 550-9050
Mailing address
PO BOX 676786, DALLAS, TX 75267-6786
(956) 548-1139
(956) 550-9050
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
K1442
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0043KH
BCBS NUMBER
TX
05
—
118823704
—
TX
01
—
200076095
EMPLOYER IDENTIFICATION N
TX
01
—
P00039432
PIN MEDICARE RAILROAD
TX
Enumeration date
11/15/2006
Last updated
05/12/2022
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