Organization Active NPI

Miguel a Gomez MD PA

  • Vascular Surgery Physician
  • Houston, TX
National Provider Identifier
1093059818
Registry record updated Jul 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
J2031 Issued in TX
Legal business name
MIGUEL A GOMEZ MD PA
Practice address
18400 Katy Fwy
Ste 480
Houston, TX 77094-1286
Phone
(832) 260-0500
Fax
(832) 260-0488
NPI assigned
Nov 16, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2013

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

Authorized official

Name
Dr. Miguel A Gomez III, M.D.NPI 1639139926
Title
President/Owner
Phone
(713) 932-6251

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X J2031 TX Primary

Addresses

Primary practice location

18400 Katy Fwy
Ste 480
Houston, TX 77094-1286

Mailing address

18400 Katy Fwy
Ste 480
Houston, TX 77094-1286
Phone (832) 260-0500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130206000194 TX Part B Supplier - Clinic/Group Practice 5496909137 Receives reassigned benefits from 1 practitioner
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

902 Frostwood Dr
Ste 144
Houston, TX 77024
Phone (713) 464-6127

18400 Katy Fwy
Ste 480
Houston, TX 77094
Phone (713) 932-6251

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372982400000",
    "number": "1093059818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18400 KATY FWY",
            "address_2": "STE 480",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770941286",
            "telephone_number": "832-260-0500",
            "fax_number": "832-260-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18400 KATY FWY",
            "address_2": "STE 480",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770941286",
            "telephone_number": "832-260-0500",
            "fax_number": "832-260-0488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIGUEL A GOMEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-16",
        "last_updated": "2013-07-05",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "713-932-6251",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "J2031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.