Individual provider Active NPI

Brian Gabriel Gomez, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1104264357
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
Brooke Army Medical Center
3551 Roger Brooke Dr.
San Antonio, TX 78234
Phone
(210) 916-5930
NPI assigned
Jun 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

Brooke Army Medical Center
3551 Roger Brooke Dr.
San Antonio, TX 78234

Mailing address

Brooke Army Medical Center
3551 Roger Brooke Dr.
San Antonio, TX 78234
Phone (210) 916-5930

Other practice location 1

1061 Harmon Ave Ste 1D03
Fort Stewart, GA 31314-5674
Phone (912) 435-6965

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL unk

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1104264357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BROOKE ARMY MEDICAL CENTER",
            "address_2": "3551 ROGER BROOKE DR.",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-916-5930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROOKE ARMY MEDICAL CENTER",
            "address_2": "3551 ROGER BROOKE DR.",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-916-5930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1061 Harmon Ave Ste 1D03",
            "address_purpose": "LOCATION",
            "city": "Fort Stewart",
            "state": "GA",
            "postal_code": "313145674",
            "country_code": "US",
            "telephone_number": "912-435-6965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "BRIAN",
        "middle_name": "GABRIEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-10",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "unk",
            "affiliation": "N",
            "address_1": "Brooke Army Medical Center",
            "address_2": "3551 Roger Brooke Dr.",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "78234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.