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General NPI Number Information
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NPI Number | 1023337839
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Entity Type | Organization
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Legal Business Name | JAIME S GOMEZ MDPA
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 05/28/2010
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Provider Practice Location Address
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Address Line | 160 PLAZA SANTA ROSA
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City | BROWNSVILLE
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State | TX
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Zip | 78520-9785
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Country | US
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Telephone | 956-504-7121
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Fax | 956-504-7246
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Provider Business Mailing Address
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Address Line | PO BOX 4217
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City | BROWNSVILLE
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State | TX
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Zip | 78523-4217
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Country | US
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Telephone | 956-504-7121
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Fax | 956-504-7246
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAIME S GOMEZ
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Credential | M.D.
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Telephone | 956-504-7121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | L3663
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License Number State | TX
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