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General NPI Number Information
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NPI Number | 1700067808
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Entity Type | Organization
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Legal Business Name | FAMILY SPECIALISTS MEDICAL CENTER PA
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 1605 E EXPRESSWAY 83 SUITE D
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City | MISSION
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State | TX
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Zip | 78572-6616
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Country | US
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Telephone | 956-585-1564
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Fax | 956-585-2830
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Provider Business Mailing Address
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Address Line | 2401 SE AUGUSTA SQ
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City | MCALLEN
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State | TX
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Zip | 78503-1105
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Country | US
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Telephone | 956-585-1564
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Fax | 956-585-2830
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FELIPE DE JESUS GOMEZ
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Credential | MD
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Telephone | 956-585-1564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | J4825
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License Number State | TX
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