Provider Demographics
NPI:1073081162
Name:GOMEZ, MERCEDES MARIA (OT)
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:MARIA
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21819 MORGAN PARK LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4851
Mailing Address - Country:US
Mailing Address - Phone:867-387-4398
Mailing Address - Fax:
Practice Address - Street 1:21819 MORGAN PARK LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-4851
Practice Address - Country:US
Practice Address - Phone:786-387-4398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120007225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist