Individual
ENRICO GULUA AGUAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
710 W MAIN STREET, CROSBYTON, TX 79322
(806) 675-7382
(806) 675-0152
Mailing address
3420 22ND PLACE, LUBBOCK, TX 79410
(806) 725-7800
(806) 723-6532
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
J1830
TX
207R00000X
Internal Medicine Physician
Primary
J1830
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140334744
—
TX
Enumeration date
04/11/2006
Last updated
10/26/2020
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