Provider Demographics
NPI:1487223962
Name:GOMEZ, ADRIANA TERESA (CF-SLP)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:TERESA
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 N EYE ST
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-2304
Mailing Address - Country:US
Mailing Address - Phone:956-970-0206
Mailing Address - Fax:
Practice Address - Street 1:4301 N 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3008
Practice Address - Country:US
Practice Address - Phone:956-687-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118280235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist