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Contact Information

ENDOVASCULAR
2240 COLLEGE DR
GALLUP, NM87301-7003
 Phone: 505-297-1052
 Fax: 505-297-1227
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Bariatric Medicine

207QB0002X 08 Physician/Family Practice
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for ENDOVASCULAR · (Female)

NPI # 1972221182
Status Active
Credentials
Entity Individual
Enumeration date 08/15/2022
Last updated 09/08/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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