Provider Demographics
NPI:1558367508
Name:GOMEZ, DALYS F (MD)
Entity Type:Individual
Prefix:
First Name:DALYS
Middle Name:F
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 1:3322 PRINCE GEORGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-3930
Mailing Address - Country:US
Mailing Address - Phone:210-687-1222
Mailing Address - Fax:210-698-1110
Practice Address - Street 1:24165 IH 10 W
Practice Address - Street 2:STE 126
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1109
Practice Address - Country:US
Practice Address - Phone:210-687-1222
Practice Address - Fax:210-698-1110
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2704174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH84092Medicare UPIN
TX611460Medicare ID - Type Unspecified