DR. GARY MICHAEL BOURGEOIS (NPI# 1629260773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629260773 |
| Entity Type | Individual |
| Full Name | DR. GARY MICHAEL BOURGEOIS |
| Credential | DDS |
| Practice Address |
1071 Country Club Rd Suite Q El Paso TX 79932-3173 |
| Practice Telephone | 9155810171 |
| Mailing Telephone | 9155810171 |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2007-08-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
0018214 | TX | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 4789 | 05 |
| Street Address |
1071 COUNTRY CLUB RD SUITE Q |
| City | EL PASO |
| State | TX |
| Zip Code | 79932-3173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568580967 | David Ledesma | Occupational Therapist | 1071 Country Club Rd, Suite F, El Paso, TX 79932-3173 | 2007-03-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659932267 | Rio Grande Pharmacy, LLC | Pharmacy | 5500 Doniphan Dr. Ste 201-202, El Paso, TX 79932 | 2019-06-25 |
| 1730676461 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 8041 N Mesa St # A, El Paso, TX 79932 | 2018-04-18 |
| 1134616063 | Barbara Jin Yoon | Nurse Practitioner | 8041 N Mesa St Ste B3, El Paso, TX 79932 | 2018-04-17 |
| 1225540370 | Epmed, Pa | Durable Medical Equipment & Medical Supplies | 7825 N. Mesa St., El Paso, TX 79932 | 2017-10-30 |
| 1386187995 | Nec El Paso Upper Valley Emergency Center, Lp | Clinic/Center | 7860 N Mesa St, El Paso, TX 79932 | 2016-11-30 |
| 1356708028 | Monica Fabiola Delgado | Health Educator | 740 Country Club Rd, El Paso, TX 79932 | 2016-01-26 |
| 1558736504 | Laura Castillo Cole | Nurse Practitioner | 5021 Crossroads Drive, El Paso, TX 79932 | 2015-12-02 |
| 1942644224 | Jessica Marie Rymer | Pediatrics | 181 Gus Rallis Dr, El Paso, TX 79932 | 2013-04-17 |
| 1053670323 | Gwendolyn N. Facison | Contractor | 732 Elmwood Ct B, El Paso, TX 79932 | 2012-05-08 |
| 1063780518 | Stacey S Grajeda | Pharmacist | 8050 N Mesa, Walgreens, El Paso, TX 79932 | 2011-12-12 |
| Find all providers in zip 79932 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790383206 | Flores Sapien Dentistry Pllc | Dentist | 8889 Gateway Blvd W Ste 1100, El Paso, TX 79925-6542 | 2020-10-16 |
| 1033729199 | Christian Diego Lepure | Dentist | 7598 N Mesa St Ste A, El Paso, TX 79912-3518 | 2020-08-04 |
| 1609494111 | Pallavi Sharma | Dentist | 201 S Americas Ave Ste 206, El Paso, TX 79907-6915 | 2020-07-10 |
| 1003434820 | Francisco Andres Escobar | Dentist | 2200 N Yardbrough Dr, Suite N, El Paso, TX 79925 | 2020-07-08 |
| 1356969315 | Julia Kathleen Escobar | Dentist | 5001 N Mesa St Apt 1304, El Paso, TX 79912-5930 | 2020-07-07 |
| 1093330789 | Access Dental of El Paso Pllc | Dentist | 8825 N Loop Dr Ste 126, El Paso, TX 79907-4606 | 2020-06-09 |
| 1912550559 | John Andrew Loiselle | Dentist | 600 Sunland Park Dr Ste 600, El Paso, TX 79912-5115 | 2019-07-23 |
| 1164083309 | Erica Lepure | Dentist | 1280 Hawkins Blvd Ste 100, El Paso, TX 79925-4949 | 2019-06-27 |
| 1710542196 | Amanda Christine Griego | Dentist | 1050 Sunland Park Dr # B200, El Paso, TX 79922-1326 | 2019-05-01 |
| 1508328451 | North Mesa Family Dental, Pllc | Dentist | 6135 N Mesa St Ste C, El Paso, TX 79912-4515 | 2019-04-01 |
| Find all providers in EL PASO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.