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Teofilo S. Bautista, M.d., P.c
Primary Care Clinic/Center in Gary, Indiana
NPI 1215110200

Teofilo S. Bautista, M.d., P.c is a Primary Care Clinic/Center based in Gary, IN and is specialized in Primary Care. Teofilo S. Bautista, M.d., P.c practices in Gary, IN. The NPI Number for Teofilo S. Bautista, M.d., P.c is 1215110200 and holds a License No. 01032450A (Indiana).

The current practice location address for Teofilo S. Bautista, M.d., P.c is 642 S Lake St, Gary, IN and can be reached out via phone at 219-938-4481 and via fax at 219-938-6480.

Location: 642 S Lake St, Gary, IN, 46403-2967
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1215110200
Provider Name
Teofilo S. Bautista, M.d., P.c
Credential
Provider Entity Type
Organization
Address
642 S Lake St, Gary, IN, 46403-2967
Phone Number
219-938-4481
Fax Number
219-938-6480
Provider Enumeration Date
12/12/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
642 S Lake St
City
Gary
State
Indiana
Zip
46403-2967
Phone Number
219-938-4481
Fax Number
219-938-6480
person
Provider Business Mailing Address Details
Address
642 S Lake St
City
Gary
State
Indiana
Zip
46403-2967
Phone Number
219-938-4481
Fax Number
219-938-6480
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
01032450A (Indiana)
Definition
Definition to come...
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