Provider Demographics
NPI:1104624345
Name:CLINICA GLORIA DE AMERICA III
Entity type:Organization
Organization Name:CLINICA GLORIA DE AMERICA III
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AYMEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JULIOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:832-323-3115
Mailing Address - Street 1:15210 INTERSTATE 45 S STE 110
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-4967
Mailing Address - Country:US
Mailing Address - Phone:832-323-3115
Mailing Address - Fax:832-323-3116
Practice Address - Street 1:15210 INTERSTATE 45 S STE 110
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-4967
Practice Address - Country:US
Practice Address - Phone:832-323-3115
Practice Address - Fax:832-323-3116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty