Provider Demographics
NPI:1609050392
Name:GOMEZ, CINDY JO (RN)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:JO
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:JO
Other - Last Name:BRANDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12041 DESSAU RD APT 1103
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-1714
Mailing Address - Country:US
Mailing Address - Phone:512-940-2762
Mailing Address - Fax:512-697-2857
Practice Address - Street 1:12041 DESSAU RD APT 1103
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-1714
Practice Address - Country:US
Practice Address - Phone:512-940-2762
Practice Address - Fax:512-697-2857
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2020-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX733657163WC1500X, 163WD0400X, 163WI0500X, 163WX0002X, 163WM0102X, 163WM0102X, 163WP0200X, 163WP1700X, 163WW0101X, 163WX0002X, 163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WX0002XNursing Service ProvidersRegistered NurseObstetric, High-Risk
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WP1700XNursing Service ProvidersRegistered NursePerinatal
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient