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General NPI Number Information
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NPI Number | 1841324340
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Entity Type | Organization
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Legal Business Name | ANTONIETA A GIMOTEA MD PA
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 04/29/2013
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Provider Practice Location Address
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Address Line | 1022 E GRIFFIN PKWY SUITE 105
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City | MISSION
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State | TX
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Zip | 78572-2400
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Country | US
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Telephone | 956-585-2822
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Fax | 956-585-2632
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Provider Business Mailing Address
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Address Line | 1022 E GRIFFIN PKWY SUITE 105
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City | MISSION
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State | TX
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Zip | 78572-2400
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Country | US
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Telephone | 956-585-2822
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Fax | 956-585-2632
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTONIETA A GIMOTEA
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Credential | MD
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Telephone | 956-585-2822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | K4434
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License Number State | TX
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