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General NPI Number Information
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NPI Number | 1902164510
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Entity Type | Organization
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Legal Business Name | STROMAN & GUTIERREZ FAMILY PRACTICE CLINIC AND MED SPA, PLLC
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Dates
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Enumeration Date | 05/02/2012
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Last Update Date | 05/02/2012
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Provider Practice Location Address
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Address Line | 400 W. EXPRESSWAY 83
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City | WESLACO
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State | TX
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Zip | 78596
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Country | US
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Telephone | 361-876-9343
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Fax |
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Provider Business Mailing Address
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Address Line | 400 W. EXPRESSWAY 83
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City | WESLACO
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State | TX
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Zip | 78596
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PAMELA STROMAN
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Credential |
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Telephone | 361-876-9343
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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 |
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License Number State |
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