Individual
MRS. CHERYL GOMEZ MANTARING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
P O BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AP137038
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
391684301
—
TX
01
—
391684302
MEDICAID CSHCN
TX
Enumeration date
07/27/2018
Last updated
02/18/2019
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