Provider Demographics
NPI:1487933347
Name:GUADALUPANA FAMILY MEDICINE
Entity type:Organization
Organization Name:GUADALUPANA FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:BIBIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LADINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-773-9873
Mailing Address - Street 1:903 S MAIN ST STE B107
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-2347
Mailing Address - Country:US
Mailing Address - Phone:972-772-9873
Mailing Address - Fax:972-773-9854
Practice Address - Street 1:903 S MAIN ST STE B107
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-2347
Practice Address - Country:US
Practice Address - Phone:972-772-9873
Practice Address - Fax:972-773-9854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3806261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care