Individual provider Active NPI

Linda Victoria Gomez, DPT

  • Physical Therapist
  • Victoria, TX
National Provider Identifier
1679832141
Registry record updated May 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1197715 Issued in TX
Practice address
4208 Retama Cir
Victoria, TX 77901-2765
Phone
(361) 582-0611
Fax
(361) 582-0555
NPI assigned
May 3, 2012
Last updated
May 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1197715 TX Primary

Addresses

Primary practice location

4208 Retama Cir
Victoria, TX 77901-2765

Mailing address

PO Box 5171
Victoria, TX 77903-5171
Phone (361) 582-0611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191204001350 TX Practitioner - Physical Therapist in Private Practice 6507299641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1197715TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Building Kid Steps, LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1679832141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5171",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779035171",
            "telephone_number": "361-582-0611",
            "fax_number": "361-582-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 RETAMA CIR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012765",
            "telephone_number": "361-582-0611",
            "fax_number": "361-582-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "LINDA",
        "middle_name": "VICTORIA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1197715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; 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.