Provider Demographics
NPI:1720238447
Name:GOMEZ, MARIA ELENA
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ELENA
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 W ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78541-8385
Mailing Address - Country:US
Mailing Address - Phone:956-358-3671
Mailing Address - Fax:956-381-0385
Practice Address - Street 1:412 W ORANGE AVE
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78541-8385
Practice Address - Country:US
Practice Address - Phone:956-358-3671
Practice Address - Fax:956-381-0385
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide