Individual
DR. GUSTAVO ANDRES GABINO-MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21 SPURS LN, STE 230B, SAN ANTONIO, TX 78240-1669
(210) 690-7400
Mailing address
4458 MEDICAL DR, STE 505, SAN ANTONIO, TX 78229-3748
(210) 690-7400
(210) 690-7405
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
P8903
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
339466001
—
TX
Enumeration date
03/13/2009
Last updated
09/24/2019
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