Provider Demographics
NPI:1134464381
Name:GOMEZ, LOIDA E
Entity Type:Individual
Prefix:
First Name:LOIDA
Middle Name:E
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3630 RIDGEBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7918
Mailing Address - Country:US
Mailing Address - Phone:214-952-0316
Mailing Address - Fax:
Practice Address - Street 1:3630 RIDGEBRIAR DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7918
Practice Address - Country:US
Practice Address - Phone:214-952-0316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion