Sunrise Total Mind Wellness Referrals
Referred by
- Referring physician: Arturo Garza-Gongora
- Referring physician contact number: 956-718-6966
- Practice name: Dr.Arturo Garza-Gongora
- Practice contact name: Priscilla
- Practice phone number: 956-718-6966
- Practice fax number: 956-795-4760
Patient information
- Preferred name: Juanita Tijerina
- DOB: June 9, 1952
- Sex: Female
- Race: White
- Preferred language: English
- Marital status: Single
- Contact number: 956251-3411
- Email address: jtwizwash@yahoo.com
- Address: 417 Mier
Laredo, Texas 78040 - Reason for visit:
evaluation and adjustments to medications. Dx: depression, anxiety, insomnia
Insurance information
- Insurance policy holder’s name: Juanita Tijerina
- Insurance policy holder’s DOB: June 9, 1952
- Primary insurance ID: 4F34Q37PY61
- Primary insurance Group: Medicare
- Secondary insurance ID:
- Secondary insurance Group: