Individual
BLANCA JENNY GOMEZ CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6565 FANNIN ST, HOUSTON, TX 77030-2703
(713) 790-3311
Mailing address
1622 N JACKSON ST, ARLINGTON, VA 22201-5223
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101276212
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2019
Last updated
09/02/2022
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