Quevedo, Ii, Enrique Mario

Quevedo, Ii, Enrique Mario is an individual health care provider with primary practice located at 800 E Dawson St , Tyler TX 75701-2036. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Quevedo, Ii, Enrique Mario can be contacted via phone (903) 531-4500.

Contact Information

Primary practice address
800 E Dawson St Tyler TX 75701-2036
Phone: (903) 531-4500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X J8727 Texas

Profile Details

NPI number 1669411955
LBN Legal business name Quevedo, Ii, Enrique Mario
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated Oct 13th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669411955 NPPES
Texas MEDICAID 101575204

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