MEDICARE: DR. JOSEPH DANIEL GOMEZ D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	12362	TX

General Provider Information

NPI Number	:	1609214840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH DANIEL GOMEZ D.C.

Provider Business Mailing Address
First Line	:	11400 SPACE CENTER BLVD
Second Line	:	APT 7202
City	:	HOUSTON
State	:	TX
Zip	:	77059-3598
Country	:	US
Telephone Number	:	713-550-7585
Fax Number	:

Provider Business Practice Location Address
First Line	:	11400 SPACE CENTER BLVD
Second Line	:	APT 7202
City	:	HOUSTON
State	:	TX
Zip	:	77059-3598
Country	:	US
Telephone Number	:	713-550-7585
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2013
Last Update Date	:	10/28/2013

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