Individual
DAVID J GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3110 NOGALITOS, SUITE 105, SAN ANTONIO, TX 78225-2337
(210) 533-0257
(210) 534-0890
Mailing address
3110 NOGALITOS, SUITE 105, SAN ANTONIO, TX 78225-2337
(210) 533-0257
(210) 531-9488
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA03024
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209627301
—
TX
01
—
377795SY18
MEDICARE PTAN
TX
Enumeration date
09/30/2005
Last updated
11/04/2019
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