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Organization
GOMEZ-VAZQUEZ FAMILY PRACTICE, PA
Active
Organization
GOMEZ-VAZQUEZ FAMILY PRACTICE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE GOMEZ-VAZQUEZ M.D. (PRESIDENT)
(956) 722-8046
Entity
Organization
Contact information
Practice address
7210 MCPHERSON RD, SUITE #115, LAREDO, TX 78041-6507
(956) 722-8046
(956) 722-8047
Mailing address
7210 MCPHERSON RD, SUITE #115, LAREDO, TX 78041-6507
(956) 722-8046
(956) 722-8047
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J-4159
TX
207Q00000X
Family Medicine Physician
J-4160
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T38Z
BCBS GROUP #
TX
01
—
1013076058
NPI
TX
01
—
1053470070
NPI
TX
Enumeration date
01/23/2007
Last updated
08/22/2020
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