Provider Demographics
NPI:1285932418
Name:OLGA L GOMEZ MD PA CHILDRENS CLINIC
Entity type:Organization
Organization Name:OLGA L GOMEZ MD PA CHILDRENS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:LUCIA
Authorized Official - Last Name:GOMEZ MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-969-1313
Mailing Address - Street 1:5111 N 10TH ST # 230
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2835
Mailing Address - Country:US
Mailing Address - Phone:956-969-1313
Mailing Address - Fax:956-969-1322
Practice Address - Street 1:910 E 8TH ST STE 3
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4675
Practice Address - Country:US
Practice Address - Phone:956-969-1313
Practice Address - Fax:956-969-1322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-11
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty