Jacobey Gonzales

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

4061388 Issued in TX

Practice address

3201 N Midland Dr Ste 130
Midland, TX 79707-0003

Phone

(432) 617-3110

NPI assigned

May 26, 2022

Last updated

May 26, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Phytex Rehabilitation, LLC

  dba PhyTEx Rehabilitation & Sports Medicine Associates

  • Physical Therapist
  • Humble, TX
  • NPI 1366937591
  NPD (past)

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1881332138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 N GRANDVIEW AVE STE 400",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797611621",
            "telephone_number": "432-617-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 N MIDLAND DR STE 130",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797070003",
            "telephone_number": "432-617-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "JACOBEY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "4061388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Nicole Gomez-Vargas
• Dorothy M Gomez, COTA
• Mekayla Katari Gomez, PTA
• Angelica Gonzales, PA-C
• Candida Gonzales, COTA
• Michael A Gonzales
• Rebecca Gonzalez, PTA
• Chernika Goodley, MA, LPC-A
• Bailey Catherine Goodrum, M.S., CCC-SLP
• Gordon W. Dyer, LLC (Gordon W. Dyer, O.D.)

• Physical Therapy Assistant in Midland, TX
• Providers in Midland, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.