Provider Demographics
NPI:1922024652
Name:GOMEZ, SANDRA P (MD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:P
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4700 W SAM HOUSTON PKWY N
Mailing Address - Street 2:STE 220
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-8224
Mailing Address - Country:US
Mailing Address - Phone:713-402-7824
Mailing Address - Fax:713-570-0196
Practice Address - Street 1:4700 W SAM HOUSTON PKWY N
Practice Address - Street 2:STE 220
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-8224
Practice Address - Country:US
Practice Address - Phone:713-402-7824
Practice Address - Fax:713-570-0196
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2021-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL1864207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00382523Medicare PIN
TX8F4217Medicare PIN
TXH04616Medicare UPIN