Provider Demographics
NPI:1316272560
Name:ALFREDO F GURMENDI MD PA
Entity type:Organization
Organization Name:ALFREDO F GURMENDI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:F
Authorized Official - Last Name:GURMENDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-334-0530
Mailing Address - Street 1:205 W BOUTZ RD
Mailing Address - Street 2:BLDG 1
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3262
Mailing Address - Country:US
Mailing Address - Phone:575-532-7000
Mailing Address - Fax:575-532-7006
Practice Address - Street 1:1200 RICHMOND AVE
Practice Address - Street 2:STE 330
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5424
Practice Address - Country:US
Practice Address - Phone:713-334-0530
Practice Address - Fax:713-334-0552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2294208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty