Individual
GUSTAVO LUGO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15386 LOPEZ RD, RAYMONDVILLE, TX 78580-9675
(956) 966-9644
Mailing address
PO BOX 691, RAYMONDVILLE, TX 78580-0691
(956) 966-9644
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
172768
TX
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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