NPIMap

Organization Active NPI

Youthful Essence Medical Skin and Laser PC

  • Anesthesiology Physician
  • Katy, TX
National Provider Identifier
1902049091
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
J4824 Issued in TX
Legal business name
YOUTHFUL ESSENCE MEDICAL SKIN AND LASER PC
Practice address
414 West Grand Parkway
115
Katy, TX 77494
Phone
(281) 693-7546
Fax
(281) 693-7548
NPI assigned
Apr 20, 2009
Last updated
Apr 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Authorized official

Name
Dr. Michael S Gomez
Title
Medical Director
Phone
(281) 693-7546

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X J4824 TX Primary
Family Medicine Physician 207Q00000X J4824 TX
Vascular Surgery Physician 2086S0129X J4824 TX

Addresses

Primary practice location

414 West Grand Parkway
115
Katy, TX 77494

Mailing address

414 West Grand Parkway
115
Katy, TX 77494
Phone (281) 693-7546

National Provider Directory

National Provider Directory
Tax ID family
Youthful Essence Medical3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

414 W Grand Pkwy S
Ste 115
Katy, TX 77494
Phone (281) 693-7546

NPI Registry JSON

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240185600000",
    "number": "1902049091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 WEST GRAND PARKWAY",
            "address_2": "115",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77494",
            "telephone_number": "281-693-7546",
            "fax_number": "281-693-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 WEST GRAND PARKWAY",
            "address_2": "115",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77494",
            "telephone_number": "281-693-7546",
            "fax_number": "281-693-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUTHFUL ESSENCE MEDICAL SKIN AND LASER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-20",
        "last_updated": "2009-04-20",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "281-693-7546",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "J4824",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J4824",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "J4824",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Katy, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.

Verify at the official NPI Registry.