Doctor Name: | DANIEL GOMEZ |
NPI Number: | 1487079752 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.A. |
License Number: | PA05902 |
Business Practice Address: | 640 S Expy 77 Ste 2 Raymondville, TX - 785804241 |
Business Phone Number: | 9566894120 |
Business Fax Number: | |
Mailing Address: | 640 S Expy 77 Ste 2, RAYMONDVILLE |
State: | TX |
Postal Code: | 785804241 |
Phone Number: | 9566894120 |
Fax Number: | |
NPI Enumeration Date: | 02/24/2014 |
NPI Last Update Date: | 02/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA05902 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |