Provider Demographics
NPI:1801891486
Name:GOMEZ, LORENA (MD)
Entity type:Individual
Prefix:DR
First Name:LORENA
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 E PAISANO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-3913
Mailing Address - Country:US
Mailing Address - Phone:915-774-2500
Mailing Address - Fax:915-774-2551
Practice Address - Street 1:5100 E PAISANO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-3913
Practice Address - Country:US
Practice Address - Phone:915-774-2500
Practice Address - Fax:915-774-2551
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5689207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX270912YLPSOtherWELLMED PTAN
NM67378Medicaid
TX320847202Medicaid
NM67378Medicaid