Individual
GUSTAVO ADOLFO FABREGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 355-8620
Mailing address
3709 NE EASTLAKE DR, LAWTON, OK 73507-4205
(225) 936-2229
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
28388
OK
Other
Enumeration date
09/26/2007
Last updated
09/12/2011
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