Active NPI
Angelica Gomez, ASLP
- Speech-Language Assistant
- Mission, TX
National Provider Identifier
1184856940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 34957
- Practice address
- 2011 E Griffin Pkwy
Mission, TX 78572-3222 - Phone
- (956) 585-2439
- Fax
- (956) 585-3145
- NPI assigned
- Aug 12, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 34957 | TX | Primary |
Addresses
Primary practice location
2011 E Griffin Pkwy
Mission, TX 78572-3222
Mailing address
3809 Pena Blanca North Rd
Mission, TX 78574-2616
Phone (956) 316-2224
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659307254 | Medicaid | TX |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34957 | TX | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jorky Inc. | Past | Accepting new patients | |
| Wiggles Children'S Rehab | Past | Accepting new patients |
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.
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Mission, TX
- NPI 1659307254
-
- Preferred Provider Organization
- Mission, TX
- NPI 1831268135
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250035200000",
"number": "1184856940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3809 PENA BLANCA NORTH RD",
"city": "MISSION",
"state": "TX",
"postal_code": "785742616",
"telephone_number": "956-316-2224",
"fax_number": "956-316-1717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2011 E GRIFFIN PKWY",
"city": "MISSION",
"state": "TX",
"postal_code": "785723222",
"telephone_number": "956-585-2439",
"fax_number": "956-585-3145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "ANGELICA",
"credential": "ASLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-12",
"last_updated": "2009-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "TX",
"license": "34957",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1659307254",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mission, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.