Individual
ANDRES EDUARDO GOMEZ VARGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
2230 LINE DR, LAWRENCEVILLE, GA 30043-2602
(786) 553-6073
(678) 585-1136
Mailing address
PO BOX 2550, ROWLETT, TX 75030-2550
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
19-413
GA
Other
Enumeration date
10/09/2019
Last updated
04/05/2022
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