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Provider Information for 1174168777

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

AMANDA GOMEZ SLP

Gender: FEMALE

Individual NPI: 1174168777

Calendar   Last Updated:  2019-11-07
  Certification Date: 

Details

Name Value
NPI 1174168777
Enumeration Date 2019-11-07
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 13333 BLANCO RD STE 310
SAN ANTONIO, TX 78216-7756
United States

Phone: 210-479-5875 | Fax: 210-479-2911
View Map External Link
Primary Practice Address 13333 BLANCO RD STE 310
SAN ANTONIO, TX 78216-7756
United States

Phone: 210-479-5875 | Fax: 210-479-2911
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 235Z00000X - Speech-Language Pathologist TX 115961