Organization
GATEWAY COMMUNITY HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIGUEL TREVINO JR. (CEO)
(956) 523-3642
Entity
Organization
Contact information
Practice address
1515 PAPPAS ST, LAREDO, TX 78041-1705
(956) 523-3642
Mailing address
1515 PAPPAS ST, LAREDO, TX 78041-1705
(956) 523-3642
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081896503
—
TX
Enumeration date
01/29/2010
Last updated
01/29/2010
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