Individual
FABIAN J GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
520 MADISON OAK DR, SAN ANTONIO, TX 78258-3913
(210) 297-4000
Mailing address
7703 FLOYD CURL DR # MC7977, SAN ANTONIO, TX 78229-3901
(210) 358-4000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05060
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184599201
—
TX
05
—
184599210
—
TX
01
—
184599211
CSHCN
TX
Enumeration date
11/14/2006
Last updated
06/22/2018
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