Provider Demographics
NPI:1437140316
Name:GOMEZ, CHINGHUEY ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHINGHUEY
Middle Name:ANNE
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 W CAMPBELL RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3465
Mailing Address - Country:US
Mailing Address - Phone:972-498-4470
Mailing Address - Fax:972-498-4537
Practice Address - Street 1:403 W CAMPBELL RD
Practice Address - Street 2:SUITE 305
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3465
Practice Address - Country:US
Practice Address - Phone:972-498-4470
Practice Address - Fax:972-498-4537
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000039027207V00000X
TXM5189207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AF080OtherBCBS
TX185257601Medicaid
TX00Y309Medicare PIN
TX8AF080OtherBCBS
TN3325410Medicare ID - Type UnspecifiedMEDICARE #