Provider Demographics
NPI:1508675109
Name:GOMEZ, CRISTAL (RN)
Entity type:Individual
Prefix:MRS
First Name:CRISTAL
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 WCR 2170
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78363
Mailing Address - Country:US
Mailing Address - Phone:956-801-1416
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 100
Practice Address - Street 2:
Practice Address - City:SARITA
Practice Address - State:TX
Practice Address - Zip Code:78385-0100
Practice Address - Country:US
Practice Address - Phone:361-294-5381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX876995163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool