Provider Demographics
NPI:1457741936
Name:STROMAN & GUTIERREZ FAMILY PRACTICE CLINIC AND MED SPA, PLLC
Entity Type:Organization
Organization Name:STROMAN & GUTIERREZ FAMILY PRACTICE CLINIC AND MED SPA, PLLC
Other - Org Name:STROMAN & GUTIERREZ FAMILY PRACTICE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:RAMIREZ
Authorized Official - Last Name:STROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-351-5330
Mailing Address - Street 1:909 JAMES ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-4209
Mailing Address - Country:US
Mailing Address - Phone:956-351-5330
Mailing Address - Fax:956-375-2724
Practice Address - Street 1:909 JAMES ST
Practice Address - Street 2:SUITE C
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4209
Practice Address - Country:US
Practice Address - Phone:956-351-5330
Practice Address - Fax:956-375-2724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9035207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM9035OtherMEDICAL LIC NO.
TX1669630752OtherINDIVIDUAL NPI