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General NPI Number Information
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NPI Number | 1508172503
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Entity Type | Individual
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Provider Name | DEBRA GOMACH D.C.
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Gender | Female
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Dates
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Enumeration Date | 08/27/2010
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 391 COLUMBIA MEMORIAL PKWY
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City | KEMAH
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State | TX
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Zip | 77565-3249
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Country | US
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Telephone | 832-730-4657
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Fax | 832-430-4675
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Provider Business Mailing Address
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Address Line | 2505 LEXINGTON CT
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City | LEAGUE CITY
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State | TX
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Zip | 77573-6310
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Country | US
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Telephone | 832-730-4657
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Fax | 832-730-4675
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 11545
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License Number State | TX
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