Individual
GEZAHGNE T BOGALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1908 HUXLEY LN, ROUND ROCK, TX 78664
(512) 743-2390
Mailing address
1908 HUXLEY LN, ROUND ROCK, TX 78664-7418
(512) 743-2390
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
320005200
TX
172A00000X
Driver
Primary
324512222
TX
Other
Enumeration date
09/29/2017
Last updated
07/21/2022
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