Individual provider Active NPI

Jorge Gomez-Vazquez, M.D.

  • Family Medicine Physician
  • Laredo, TX
National Provider Identifier
1053470070
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J-4160 Issued in TX
Practice address
6423 McPherson Rd Ste 13
Laredo, TX 78041-6144
Phone
(956) 452-1457
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J-4160 TX Primary

Addresses

Primary practice location

6423 McPherson Rd Ste 13
Laredo, TX 78041-6144

Mailing address

6423 McPherson Rd Ste 13
Laredo, TX 78041-6144
Phone (956) 452-1457

Other identifiers 3

IdentifierTypeStateIssuer
118617303MedicaidTX
J-4160OtherTXTEXAS PHYSICAN PERMIT
N0087586OtherTXDPS REGISTRATION NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111208000777 TX Practitioner - Family Practice 5092990630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at San Antonio, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinica San Jose PLLCGroup PAC ID 9436690666, 2 clinicians

Practice addresses (Care Compare)

6423 McPherson Rd
Suite 13
Laredo, TX 78041-6144
Phone (956) 452-1457

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
J-4160TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinica San Jose PLLC Family Medicine CurrentSince Aug 5, 2024 Accepting new patients
Doctors Hospital of Laredo PastSince Jun 29, 2007 Accepting new patients

Locations

6423 McPherson Rd
Ste 13
Laredo, TX 78041
Phone (956) 452-1457

Interoperability endpoints

  • Direct secure messaging: jorge.gomezvazquez@415054778073092.direct.elationemr.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CGHEDD/Endpoint/CGHEDD

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1053470070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6423 MCPHERSON RD STE 13",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416144",
            "telephone_number": "956-452-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6423 MCPHERSON RD STE 13",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780416144",
            "telephone_number": "956-452-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ-VAZQUEZ",
        "first_name": "JORGE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J-4160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118617303",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS PHYSICAN PERMIT",
            "identifier": "J-4160",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS REGISTRATION NUMBER",
            "identifier": "N0087586",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.