Individual
GUSTAVO JAVIER MEDELLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7700 FLOYD CURL DR, SAN ANTONIO, TX 78229-3902
(210) 575-4000
Mailing address
PO BOX 1158, SAN ANTONIO, TX 78294-1158
(210) 558-6288
(210) 558-6289
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
K0129
TX
208M00000X
Hospitalist Physician
Primary
K0129
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164101101
—
TX
Enumeration date
01/09/2006
Last updated
11/06/2020
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