Provider Demographics
NPI:1235140914
Name:ASUNCION-GIMOTEA, ANTONIETA P (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTONIETA
Middle Name:P
Last Name:ASUNCION-GIMOTEA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANTONIETA
Other - Middle Name:P
Other - Last Name:ASUNCION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1022 E GRIFFIN PKWY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2400
Mailing Address - Country:US
Mailing Address - Phone:956-585-2822
Mailing Address - Fax:956-585-2632
Practice Address - Street 1:1022 E GRIFFIN PKWY
Practice Address - Street 2:SUITE 105
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2400
Practice Address - Country:US
Practice Address - Phone:956-585-2822
Practice Address - Fax:956-585-2632
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4434208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG81901Medicare UPIN