Individual
MARICELA D GULBRONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3533 S ALAMEDA ST, CORPUS CHRISTI, TX 78411-1721
(361) 694-5650
(361) 694-4257
Mailing address
PO BOX 9336, CORPUS CHRISTI, TX 78469-9336
(361) 694-1603
(361) 694-6544
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
9900857
NC
208000000X
Pediatrics Physician
TP387
KY
2080P0006X
Developmental - Behavioral Pediatrics Physician
9900857
NC
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
K0484
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5911657
—
NC
01
—
Q0085N
S.C. MEDICAID
SC
Enumeration date
06/03/2006
Last updated
06/26/2014
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