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General NPI Number Information
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NPI Number | 1053821025
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Entity Type | Organization
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Legal Business Name | GOMEZ FAMILY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 10/04/2017
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Last Update Date | 08/09/2021
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Provider Practice Location Address
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Address Line | 2211 FRY RD STE O
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City | KATY
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State | TX
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Zip | 77449-6233
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Country | US
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Telephone | 832-321-3452
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Fax | 833-746-4523
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Provider Business Mailing Address
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Address Line | 2211 FRY RD STE O
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City | KATY
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State | TX
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Zip | 77449-6233
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Country | US
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Telephone | 832-321-3452
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NATHAN DAVID GOMEZ
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Credential | D.C.
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Telephone | 210-618-5180
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 12889
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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