| Gutierrez-wong Medical Center | |
|
122 W Champion St Edinburg TX 78539-4429 | |
| (956) 287-1207 | |
| Not Available |
| Full Name | Gutierrez-wong Medical Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 122 W Champion St, Edinburg, Texas |
| Authorized Official Name and Position | Antonio Wong (GENERAL PARTNER OWNER) |
| Authorized Official Contact | 9562871207 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gutierrez-wong Medical Center 122 W Champion St Edinburg TX 78539-4429 Ph: (956) 287-1207 | Gutierrez-wong Medical Center 122 W Champion St Edinburg TX 78539-4429 Ph: (956) 287-1207 |
| NPI Number | 1770604688 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 03/27/2008 |
| Medicare PECOS PAC ID | 8729164405 |
|---|---|
| Medicare Enrollment ID | O20080320000216 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770604688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | K1137 (Texas) | Secondary |
| Provider Name | Antonio Wong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932206315 PECOS PAC ID: 0244215820 Enrollment ID: I20070510000575 |
| Provider Name | Jessica Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124321096 PECOS PAC ID: 9537331228 Enrollment ID: I20110929000718 |
| Provider Name | Mary Jane Hortelano Cubillas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356065320 PECOS PAC ID: 6305212341 Enrollment ID: I20221017002594 |
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