Provider Demographics
NPI:1306830310
Name:GOMEZ, JULIAN III (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIAN
Middle Name:
Last Name:GOMEZ
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1801 S 5TH ST
Mailing Address - Street 2:STE 124
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-2927
Mailing Address - Country:US
Mailing Address - Phone:956-630-2786
Mailing Address - Fax:956-630-4329
Practice Address - Street 1:1801 S 5TH ST
Practice Address - Street 2:STE 124
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-2927
Practice Address - Country:US
Practice Address - Phone:956-630-2786
Practice Address - Fax:956-630-4329
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE09352086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX826013917OtherRAILROAD MEDICARE