MEDICARE: DR. ANA LAURA GOMEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	L6914	TX

General Provider Information

NPI Number	:	1225174840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANA LAURA GOMEZ MD

Provider Business Mailing Address
First Line	:	2500 BUDDY OWENS AVE
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-5464
Country	:	US
Telephone Number	:	956-686-5311
Fax Number	:	956-686-7690

Provider Business Practice Location Address
First Line	:	2500 BUDDY OWENS AVE
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78504-5464
Country	:	US
Telephone Number	:	956-686-5311
Fax Number	:	956-686-7690

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	07/08/2007

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