Provider Demographics
NPI:1659198554
Name:FRONTIER MEDICINE PLLC
Entity type:Organization
Organization Name:FRONTIER MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:M
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-251-0425
Mailing Address - Street 1:220 W HILLSIDE
Mailing Address - Street 2:BUILDING 5B
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6903
Mailing Address - Country:US
Mailing Address - Phone:956-251-0425
Mailing Address - Fax:
Practice Address - Street 1:220 W HILLSIDE
Practice Address - Street 2:BUILDING 5B
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6903
Practice Address - Country:US
Practice Address - Phone:956-251-0425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty