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NPI Code Detail

MEDICARE: TERESA GOMEZ SLP

MEDICARE: TERESA GOMEZ SLP
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
1235Z00000XSpeech-Language Pathologist14329TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
114329OTHERTXSPEECH LANGUAGE PATHOLOGIST

General Provider Information

NPI Number : 1053494070
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA GOMEZ SLP
Provider Business Mailing Address
First Line : 1101 E SCHUSTER AVE
Second Line :
City : EL PASO
State : TX
Zip : 79902-4659
Country : US
Telephone Number : 915-544-8484
Fax Number : 915-496-0751
Provider Business Practice Location Address
First Line : 1101 E SCHUSTER AVE
Second Line :
City : EL PASO
State : TX
Zip : 79902-4659
Country : US
Telephone Number : 915-544-8484
Fax Number : 915-496-0751
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2006
Last Update Date : 04/11/2018

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Directions to “ TERESA GOMEZ SLP” Practice Location

Language Start Address Practice Location
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