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Individual

KENNEDY NICOLE GOMBERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2323 N CENTRAL EXPY, RICHARDSON, TX 75080-2712
(214) 453-4533
Mailing address
2323 N CENTRAL EXPY, RICHARDSON, TX 75080-2712

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA19009
TX
363AS0400X
Surgical Physician Assistant
Primary
PA19009
TX

Other

Enumeration date
12/13/2023
Last updated
08/14/2025
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