Individual
ISAIRA GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9410 DUGAS DR STE 118, SAN ANTONIO, TX 78245-1869
(210) 447-7041
Mailing address
9410 DUGAS DR STE 118, SAN ANTONIO, TX 78245-1869
(210) 447-7041
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
40009
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201914530
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/21/2019
Last updated
02/21/2019
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