Provider Demographics
NPI:1669993143
Name:GOMEZ DE ZIEGLER, CAROLINA (MD)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:GOMEZ DE ZIEGLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ROBIN AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2270
Mailing Address - Country:US
Mailing Address - Phone:956-534-6150
Mailing Address - Fax:
Practice Address - Street 1:2810 W EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-9704
Practice Address - Country:US
Practice Address - Phone:956-296-1831
Practice Address - Fax:956-296-2970
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-05
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS3388207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH08MV75301OtherBCBS