Provider Demographics
NPI:1932751062
Name:GOMEZ DENTAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:GOMEZ DENTAL SOLUTIONS LLC
Other - Org Name:GOMEZ DENTAL FAMILY PRACTICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/GENERAL DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-553-9171
Mailing Address - Street 1:902 NORMANDY ST STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-4952
Mailing Address - Country:US
Mailing Address - Phone:713-453-9926
Mailing Address - Fax:713-453-9927
Practice Address - Street 1:902 NORMANDY ST STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-4952
Practice Address - Country:US
Practice Address - Phone:713-453-9926
Practice Address - Fax:713-453-9927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX25658OtherTSBDE