Provider Demographics
NPI:1104792795
Name:GOMEZ, ROY (DC)
Entity type:Individual
Prefix:MR
First Name:ROY
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 SE 20TH ST
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-8018
Mailing Address - Country:US
Mailing Address - Phone:940-325-8096
Mailing Address - Fax:
Practice Address - Street 1:509 N HAMPTON RD STE 100A
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4970
Practice Address - Country:US
Practice Address - Phone:469-297-6575
Practice Address - Fax:972-217-3196
Is Sole Proprietor?:No
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16673111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation