Provider Demographics
NPI:1669716221
Name:GOMEZ, PAMELA MARIA (SLPA)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:MARIA
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3013 E MAIN AVE STE E
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:TX
Mailing Address - Zip Code:78573-0932
Mailing Address - Country:US
Mailing Address - Phone:956-581-7200
Mailing Address - Fax:956-581-7201
Practice Address - Street 1:3013 E MAIN AVE STE E
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:TX
Practice Address - Zip Code:78573
Practice Address - Country:US
Practice Address - Phone:956-581-7200
Practice Address - Fax:956-581-7201
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX350312355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant