Doctor Name: | MS. SUSIE M GOMEZ |
NPI Number: | 1467688721 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS SLP CCC |
License Number: | 24744 |
Business Practice Address: | 117 Medical Dr Suite 4 Victoria, TX - 779043102 |
Business Phone Number: | 3615750681 |
Business Fax Number: | 3615750100 |
Mailing Address: | 117 Medical Dr Ste 4, VICTORIA |
State: | TX |
Postal Code: | 779043114 |
Phone Number: | 3615750681 |
Fax Number: | 3615750100 |
NPI Enumeration Date: | 06/01/2009 |
NPI Last Update Date: | 09/28/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 24744 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |