Provider Demographics
NPI:1578505772
Name:GOMEZ, HECTOR L (MD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:L
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 BARLITE BLVD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1361
Mailing Address - Country:US
Mailing Address - Phone:210-927-1832
Mailing Address - Fax:210-927-3426
Practice Address - Street 1:7500 BARLITE BLVD
Practice Address - Street 2:STE 213
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1361
Practice Address - Country:US
Practice Address - Phone:210-927-1832
Practice Address - Fax:210-927-3426
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9556207RP1001X
TXN7619207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018327Medicaid
NV002018327Medicaid
NV34898Medicare ID - Type Unspecified