Provider Demographics
NPI:1033171251
Name:GOMEZ, REBECCA (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2483 BRITT DR
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-2994
Mailing Address - Country:US
Mailing Address - Phone:940-464-0361
Mailing Address - Fax:940-234-0918
Practice Address - Street 1:8501 FM 407
Practice Address - Street 2:
Practice Address - City:DOUBLE OAK
Practice Address - State:TX
Practice Address - Zip Code:75077-3031
Practice Address - Country:US
Practice Address - Phone:972-966-1980
Practice Address - Fax:940-234-0918
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3664207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI22862Medicare UPIN