Provider Demographics
NPI:1114397031
Name:GOMEZ TRANSITIONS MHT, LLC
Entity Type:Organization
Organization Name:GOMEZ TRANSITIONS MHT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PAYOR RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-633-4663
Mailing Address - Street 1:1575 HERITAGE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3288
Mailing Address - Country:US
Mailing Address - Phone:844-633-4663
Mailing Address - Fax:
Practice Address - Street 1:1575 HERITAGE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MCKINNEY
Practice Address - State:TEXAS
Practice Address - Zip Code:75069
Practice Address - Country:UM
Practice Address - Phone:844-633-4663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty