Provider Demographics
NPI:1518547108
Name:PULGAR ESCOBAR, GUSTAVO ALFREDO (MD)
Entity type:Individual
Prefix:
First Name:GUSTAVO
Middle Name:ALFREDO
Last Name:PULGAR ESCOBAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23900 KATY FWY STE W2100
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1323
Mailing Address - Country:US
Mailing Address - Phone:281-644-8111
Mailing Address - Fax:
Practice Address - Street 1:2102 TREASURE HILLS BLVD
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8736
Practice Address - Country:US
Practice Address - Phone:956-296-1491
Practice Address - Fax:956-389-4603
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXV0515208M00000X, 207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program