Basic Information
Provider Information
NPI: 1992952758
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GAMEZ
FirstName: JOSE
MiddleName: DAVID
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2646
Address2:  
City: MCALLEN
State: TX
PostalCode: 785022646
CountryCode: US
TelephoneNumber: 9563625650
FaxNumber: 9563622574
Practice Location
Address1: 2821 MICHAELANGELO DR STE 102B
Address2:  
City: EDINBURG
State: TX
PostalCode: 785391411
CountryCode: US
TelephoneNumber: 9563625650
FaxNumber: 9563622599
Other Information
ProviderEnumerationDate: 08/24/2008
LastUpdateDate: 05/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0205XP8776TXY Allopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology

No ID Information.


Home