Doctor Name: | LUIS GERARDO CABAN |
NPI Number: | 1003288994 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CSA |
License Number: | |
Business Practice Address: | 934 Arbor Pine Tomball, TX - 77375 |
Business Phone Number: | 8328879037 |
Business Fax Number: | 2812558693 |
Mailing Address: | Po Box 692186, HOUSTON |
State: | TX |
Postal Code: | 772692186 |
Phone Number: | 8328879037 |
Fax Number: | 2812558693 |
NPI Enumeration Date: | 10/30/2015 |
NPI Last Update Date: | 10/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |