Provider Demographics
NPI:1922368703
Name:GOMEZ, RAY (DPT)
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6204 HILLSIDE RD
Mailing Address - Street 2:STE 1000
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-7196
Mailing Address - Country:US
Mailing Address - Phone:806-355-7633
Mailing Address - Fax:806-355-7644
Practice Address - Street 1:6204 HILLSIDE RD
Practice Address - Street 2:STE 1000
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-7196
Practice Address - Country:US
Practice Address - Phone:806-355-7633
Practice Address - Fax:806-355-7644
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11843902251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic