Individual
LIZETTE GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
903 W MARTIN ST, SAN ANTONIO, TX 78207-0903
(210) 358-5437
(210) 358-5890
Mailing address
PO BOX 87, SAN ANTONIO, TX 78291-0087
(210) 358-9172
(210) 358-9183
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J4158
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125070608
—
TX
01
—
125070609
CSHCN
TX
Enumeration date
08/24/2006
Last updated
08/11/2014
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