| Doctor Name: | JOSE LUIS GOMEZ |
| NPI Number: | 1861848301 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 9807 Mines Rd Ste 16 Laredo, TX - 780458475 |
| Business Phone Number: | 9567743333 |
| Business Fax Number: | |
| Mailing Address: | 9807 Mines Rd Ste 16, LAREDO |
| State: | TX |
| Postal Code: | 780458475 |
| Phone Number: | 9567743333 |
| Fax Number: | |
| NPI Enumeration Date: | 05/13/2016 |
| NPI Last Update Date: | 05/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |