Provider Demographics
NPI:1164870663
Name:GOMEZ, JOSHUA (DC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
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 1:5425 HIGHWAY 6 STE A300
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4392
Mailing Address - Country:US
Mailing Address - Phone:210-379-1819
Mailing Address - Fax:
Practice Address - Street 1:5425 HIGHWAY 6 STE A300
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4392
Practice Address - Country:US
Practice Address - Phone:210-379-1819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor