Individual provider Active NPI

Jacob Gomez, RPH

  • Critical Care Pharmacist
  • El Paso, TX
National Provider Identifier
1487252110
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care PharmacistTaxonomy code 1835C0205X
License
67653 Issued in TX
Practice address
9428 Dyer St
El Paso, TX 79924-6408
Phone
(915) 751-2494
NPI assigned
Oct 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Pharmacist 1835C0205X 67653 TX Primary

Addresses

Primary practice location

9428 Dyer St
El Paso, TX 79924-6408

Mailing address

9428 Dyer St
El Paso, TX 79924-6408
Phone (915) 751-2494

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
67653TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1487252110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9428 DYER ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799246408",
            "telephone_number": "915-751-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9428 DYER ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799246408",
            "telephone_number": "915-751-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JACOB",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835C0205X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Critical Care",
            "state": "TX",
            "license": "67653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.