Individual
DR. VENTZISLAV D VANGUELOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
806 W 3RD ST, SAN JUAN, TX 78589
(956) 787-0787
Mailing address
PO BOX 1689, PHARR, TX 78577-1630
(956) 787-0787
(956) 787-2021
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
L9946
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173021001
—
TX
01
—
TXB133201
MEDICARE
TX
Enumeration date
07/13/2005
Last updated
08/31/2018
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