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General NPI Number Information
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NPI Number | 1093059818
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Entity Type | Organization
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Legal Business Name | MIGUEL A GOMEZ MD PA
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Dates
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Enumeration Date | 11/16/2012
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Last Update Date | 07/05/2013
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Provider Practice Location Address
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Address Line | 18400 KATY FWY STE 480
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City | HOUSTON
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State | TX
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Zip | 77094-1286
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Country | US
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Telephone | 832-260-0500
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Fax | 832-260-0488
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Provider Business Mailing Address
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Address Line | 18400 KATY FWY STE 480
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City | HOUSTON
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State | TX
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Zip | 77094-1286
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Country | US
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Telephone | 832-260-0500
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Fax | 832-260-0488
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. MIGUEL A GOMEZ III
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Credential | M.D.
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Telephone | 713-932-6251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | J2031
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License Number State | TX
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