Individual provider Active NPI

David Gomez

  • Public Health & General Preventive Medicine Physician
  • Mission, TX
National Provider Identifier
1407275407
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
S4635 Issued in TX
Practice address
1605 E Interstate Highway 2
Mission, TX 78572-6616
Phone
(956) 585-1564
NPI assigned
Apr 8, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083P0901X S4635 TX Primary

Addresses

Primary practice location

1605 E Interstate Highway 2
Mission, TX 78572-6616

Mailing address

1605 E Interstate Highway 2
Mission, TX 78572-6616

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
I20200813001195 TX Practitioner - Preventive Medicine 8123247848

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S4635TXMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Specialists Medical Center PA Single Specialty PastSince Aug 1, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: david.gomez.2@15119.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1407275407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 E INTERSTATE HIGHWAY 2",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 E INTERSTATE HIGHWAY 2",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785726616",
            "telephone_number": "956-585-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "DAVID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "TX",
            "license": "S4635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

Verify at the official NPI Registry.