Provider Demographics
NPI:1508434077
Name:RESENDEZ, GUS
Entity Type:Individual
Prefix:MR
First Name:GUS
Middle Name:
Last Name:RESENDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 GUERRERO ST STE B
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8018
Mailing Address - Country:US
Mailing Address - Phone:956-372-5983
Mailing Address - Fax:
Practice Address - Street 1:21 GUERRERO ST STE B
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8018
Practice Address - Country:US
Practice Address - Phone:956-372-5983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health