Gustavo Lugo Jr.

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

172768 Issued in TX

Practice address

15386 Lopez Rd
Raymondville, TX 78580-9675

Phone

(956) 966-9644

NPI assigned

Aug 24, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1992472393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 691",
            "city": "RAYMONDVILLE",
            "state": "TX",
            "postal_code": "785800691",
            "telephone_number": "956-966-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15386 LOPEZ RD",
            "city": "RAYMONDVILLE",
            "state": "TX",
            "postal_code": "785809675",
            "telephone_number": "956-966-9644"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15123 Lopez Rd",
            "address_purpose": "LOCATION",
            "city": "Raymondville",
            "state": "TX",
            "postal_code": "785809677",
            "country_code": "US",
            "telephone_number": "956-966-9644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUGO",
        "first_name": "GUSTAVO",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "172768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John W Kristensen, M.D.
• La Jarra Adult Day Care, LLC
• La Jarra Assisted Living Facility
• Sandra Reyes Lopez, REGISTERED DIETICIAN
• Laura Ann Loya, PTA
• Majadas Wellness Services LLC
• Rosa Veronica Manrique, M.D.
• Mario a Sanchez DO
• Miguel A Martinez-Vela, M.D.
• Taylor Francine Martinez, PA

• Surgical Assistant in Raymondville, TX
• Providers in Raymondville, TX by specialty
• Surgical Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.