Individual
GUSTAVO S ODERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
S8221
TX
2086S0129X
Vascular Surgery Physician
41799
AZ
2086S0129X
Vascular Surgery Physician
43750
MN
2086S0129X
Vascular Surgery Physician
ME143785
FL
2086S0129X
Vascular Surgery Physician
Primary
S8221
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
412608803
—
TX
01
—
412608804
CSHCN
TX
Enumeration date
02/16/2006
Last updated
02/13/2025
Update your record
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