Provider Demographics
NPI:1598162372
Name:GAMEZ, YVONNE YVETTE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:YVETTE
Last Name:GAMEZ
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E 1ST ST APT 320
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102-3205
Mailing Address - Country:US
Mailing Address - Phone:806-282-8660
Mailing Address - Fax:
Practice Address - Street 1:601 E 1ST ST APT 320
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-3205
Practice Address - Country:US
Practice Address - Phone:806-282-8660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-22
Last Update Date:2014-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100515235Z00000X
NM4185235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist