Provider Demographics
NPI:1780152702
Name:GOMS RANGANATH LLC
Entity type:Organization
Organization Name:GOMS RANGANATH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW / ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GOMATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:RANGANATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-894-2844
Mailing Address - Street 1:2414 LINWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2907
Mailing Address - Country:US
Mailing Address - Phone:713-894-2844
Mailing Address - Fax:713-278-1507
Practice Address - Street 1:2414 LINWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2907
Practice Address - Country:US
Practice Address - Phone:713-894-2844
Practice Address - Fax:713-278-1507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147109604Medicaid